FURP.ORG / PUBLIC DATA EXPLORER

CITIZENS MEMORIAL HEALTH CARE FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
CITIZENS MEMORIAL HEALTH CARE FOUNDATION (EIN 43-1425356)
Tax period
2015-06-01 to 2016-05-31
Filed
2017-04-18
IRS object ID
201701089349300020
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-04-18T10:36:54-05:00ReturnTs
Tax Period End2016-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN431425356EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CITIZENS MEMORIAL HEALTH CARE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% RENEE MEYERInCareOfNm
Business Name ControlCITIBusinessNameControlTxt
Phone4173266000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11500 N OAKLAND AVENUEAddressLine1Txt
CityBOLIVARCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65613ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDONALD J BABBPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Signature2017-01-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDONALD J BABBPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11500 N OAKLAND AVENUEAddressLine1Txt
CityBOLIVARCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65613ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$77,253,788GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CITIZENSMEMORIAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateMOLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION CARES FOR EVERY GENERATION THROUGH EXCEPTIONAL SERVICES BY LEADING PHYSICIANS AND A COMPASSIONATE HEALTH TEAM. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee976TotalEmployeeCnt
Total Volunteers90TotalVolunteersCnt
Total Gross UBI$29,665TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$24,348NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$244,003PYContributionsGrantsAmt
CY Contributions Grants$160,804CYContributionsGrantsAmt
PY Program Service Revenue$44,523,921PYProgramServiceRevenueAmt
CY Program Service Revenue$45,367,861CYProgramServiceRevenueAmt
PY Investment Income$27,327PYInvestmentIncomeAmt
CY Investment Income$950,849CYInvestmentIncomeAmt
PY Other Revenue-$39,114PYOtherRevenueAmt
CY Other Revenue-$66,990CYOtherRevenueAmt
PY Total Revenue$44,756,137PYTotalRevenueAmt
CY Total Revenue$46,412,524CYTotalRevenueAmt
PY Grants And Similar Paid$109,971PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$103,434CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,346,284PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$26,112,262CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$18,304,884PYOtherExpensesAmt
CY Other Expenses$18,808,683CYOtherExpensesAmt
PY Total Expenses$43,761,139PYTotalExpensesAmt
CY Total Expenses$45,024,379CYTotalExpensesAmt
PY Revenues Less Expenses$994,998PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,388,145CYRevenuesLessExpensesAmt
Total Assets BOY$69,091,754TotalAssetsBOYAmt
Total Assets EOY$43,091,152TotalAssetsEOYAmt
Total Liabilities BOY$53,562,444TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,161,939TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,529,310NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,929,213NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO SUPPORT AND ASSIST CITIZENS MEMORIAL HOSPITAL DISTRICT, OR ITS SUCCESSORS, OR ANY HEALTH CARE INSTITUTION WITH WHICH IT MAY MERGE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$23,450,768ExpenseAmt
Revenue$32,494,269RevenueAmt
DescPROVIDE LONG TERM CARE SERVICES TO MEDICAID RECIPIENTS (APPROXIMATELY 106,223 RESIDENT DAYS) IN SKILLED FACILITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,995,798ExpenseAmt
Revenue$3,863,175RevenueAmt
DescPROVIDE HOME CHORE SERVICES TO PEOPLE LIVING AT HOME BUT UNABLE TO COMPLETELY CARE FOR THEMSELVES. THROUGH HOMEMAKER PLUS, 22,097 SERVICE UNITS WERE PROVIDED THROUGH LIGHT HOUSEKEEPING, LAUNDRY, SHOPPING AND RESPITE CARE SERVICES. DURING THE FISCAL YEAR, HOME HEALTH VISITS TOTALED 11,507 AND HOSPICE PATIENT DAYS WERE 11,687. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,109,112ExpenseAmt
Revenue$1,574,571RevenueAmt
DescPROVIDE RESIDENTIAL CARE SERVICES FOR THE ELDERLY TO APPROXIMATELY 27,372 RESIDENT DAYS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$6,484,295TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$103,434TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$7,435,846TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$34,039,973TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationYes (true)PartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document99IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee976EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRENEE MEYERPersonNm
Phone4173286258PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11500 NORTH OAKLAND AVEAddressLine1Txt
CityBOLIVARCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65613ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DONALD J BABB
EXECUTIVE DIRECTOR20.040.0Yes (X)Yes (X)$146,983$370,717$20,798
DAVE STRADER
BOARD PRESIDENT1.00.0Yes (X)Yes (X)$0$0$0
BRAD GREGORY
BOARD VICE PRESIDENT1.01.0Yes (X)Yes (X)$0$0$0
DEREK HUNTER
BOARD MEMBER1.00.0Yes (X)$0$0$0
D MICHEALE MEENTS
BOARD MEMBER1.00.0Yes (X)$0$0$0
NEALE JOHNSON
BOARD MEMBER1.00.0Yes (X)$0$0$0
RUSSEL PAYNE
BOARD MEMBER1.00.0Yes (X)$0$0$0
WILLIAM DONNELL
BOARD MEMBER/PHYSICIAN3.045.0Yes (X)$1,200$199,531$8,739
GARY FULBRIGHT
BOARD TREASURER - NONVOTING1.045.0Yes (X)$0$271,247$19,433
CATHERINE MOLDER
BOARD SECRETARY - NONVOTING1.045.0Yes (X)$0$103,612$11,198
RENEE MEYER
DIRECTOR OF FINANCE45.01.0Yes (X)$196,560$0$16,542
TIM FRANCKA
ADMIN DIR OF LTC45.00.0$135,000$0$12,309Yes (X)
CHRIS MCBRATNEY
ADMIN DIR OF LTC45.00.0$121,943$0$18,396Yes (X)
KENNETH SCHANDA
DIR OF REHAB SVCS45.00.0$124,382$0$9,195Yes (X)
THERESA K DILL
ADMINISTRATOR45.00.0$102,149$0$8,505Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$828,217TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$945,107TotReportableCompRltdOrgAmt
Total Other Compensation$125,115TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

ServicesServicesDescCompensationCompensationAmtAddress Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCd
DEWITT AND ASSOCIATES
CONSTRUCTION CONTR$4,588,242
MORELOCK ROSS BUILDERS INC
CONST CONTRACTOR$2,683,401
BKD
COLSUTING/AUDIT/TAX$174,675LLPSPRINGFIELDMO65806
HMN
ARCHITECT FEES-CONST$102,535ARCHITECTSOVERLAND PARKKS66210
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Fundraising$85,577FundraisingAmt
All Other Contributions$75,227AllOtherContributionsAmt
Total Contributions$160,804TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE623000$41,441,026$41,441,026
RENT INCOME531120$3,192,426$3,192,426
MANAGEMENT FEE623000$443,936$443,936
CAFETERIA722514$136,224$136,224
TRANSIT900099$104,985$104,985

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,264TotalRevenueColumnAmt
Related Or Exempt Func Income$49,264RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$45,367,861TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$65,365TotalRevenueColumnAmt
Exclusion$65,365ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$750,968RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$378,638RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$372,330RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$372,330TotalRevenueColumnAmt
Unrelated Business Revenue$29,665UnrelatedBusinessRevenueAmt
Exclusion$342,665ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$31,180,828OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$30,295,344OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$885,484OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$885,484TotalRevenueColumnAmt
Exclusion$885,484ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$38,538FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$85,577ContriRptFundraisingEventAmt
Fundraising Direct Expenses$167,282FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$128,744TotalRevenueColumnAmt
Exclusion-$128,744ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescLOSS ON EXTINGUISHMENT OF DEBTDesc
Business900099BusinessCd
Total Revenue Column-$310,576TotalRevenueColumnAmt
Exclusion-$310,576ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total-$310,576OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,412,524TotalRevenueColumnAmt
Related Or Exempt Func Income$45,367,861RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$29,665UnrelatedBusinessRevenueAmt
Exclusion$854,194ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$103,434TotalAmt
Program Services$103,434ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$362,630TotalAmt
Management And General$362,630ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$19,116,688TotalAmt
Program Services$16,147,524ProgramServicesAmt
Management And General$2,969,164ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$588,189TotalAmt
Program Services$418,477ProgramServicesAmt
Management And General$169,712ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,518,558TotalAmt
Program Services$3,231,286ProgramServicesAmt
Management And General$1,287,272ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,526,197TotalAmt
Program Services$1,091,417ProgramServicesAmt
Management And General$434,780ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,184,900TotalAmt
Program Services$77,328ProgramServicesAmt
Management And General$2,107,572ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,610TotalAmt
Management And General$15,610ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$128,559TotalAmt
Management And General$128,559ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$215,888TotalAmt
Program Services$202,132ProgramServicesAmt
Management And General$13,756ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$65,575TotalAmt
Management And General$65,575ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,955,663TotalAmt
Program Services$2,102,498ProgramServicesAmt
Management And General$853,165ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$231,450TotalAmt
Program Services$39,707ProgramServicesAmt
Management And General$191,743ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,702,252TotalAmt
Program Services$1,130,722ProgramServicesAmt
Management And General$571,530ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$330,032TotalAmt
Program Services$116,643ProgramServicesAmt
Management And General$213,389ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$45,237TotalAmt
Program Services$15,629ProgramServicesAmt
Management And General$29,608ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,036,714TotalAmt
Program Services$1,407,989ProgramServicesAmt
Management And General$628,725ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,802,251TotalAmt
Program Services$1,937,208ProgramServicesAmt
Management And General$865,043ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,500TotalAmt
Program Services$1,500ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$3,103,127$3,103,127
PROVIDER TAX & FEES$2,455,737$2,455,737
BAD DEBT$364,026$364,026
LICENSES, DUES, SUBSCRIPTIONS$60,599$60,599

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$109,563TotalAmt
Program Services$93,589ProgramServicesAmt
Management And General$15,974ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$45,024,379TotalAmt
Program Services$34,039,973ProgramServicesAmt
Management And General$10,984,406ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$740,512BOYAmt
EOY$596,646EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,400,305BOYAmt
EOY$3,315,791EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$30,474BOYAmt
EOY$22,892EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,593,761BOYAmt
EOY$3,542,495EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$115,793BOYAmt
EOY$108,281EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$616,533BOYAmt
EOY$296,671EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$62,684,736LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$30,875,574LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$55,765,735BOYAmt
EOY$31,809,162EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,265,652BOYAmt
EOY$1,982,263EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$169,868BOYAmt
EOY$428,160EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$983,286BOYAmt
EOY$983,286EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$409,835BOYAmt
EOY$5,505EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$69,091,754BOYAmt
EOY$43,091,152EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,281,751BOYAmt
EOY$4,484,120EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$126,920BOYAmt
EOY$110,486EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,870,000BOYAmt
EOY$12,665,000EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$47,727BOYAmt
EOY$45,072EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$21,232,102BOYAmt
EOY$8,292,682EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$3,944BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$564,579EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$53,562,444BOYAmt
EOY$26,161,939EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,931,940BOYAmt
EOY$15,341,535EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,597,370BOYAmt
EOY$1,587,678EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,529,310BOYAmt
EOY$16,929,213EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$69,091,754BOYAmt
EOY$43,091,152EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,388,145ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$13,474NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$25,232OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,734,023CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$191,699CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$405,354CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$244,003CurrentTaxYearMinus1YearAmt
Current Tax Year$160,804CurrentTaxYearAmt
Total$4,735,883TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$33,329,516CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$37,850,394CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$42,747,132CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$44,523,921CurrentTaxYearMinus1YearAmt
Current Tax Year$45,367,861CurrentTaxYearAmt
Total$203,818,824TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$37,063,539CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$38,042,093CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$43,152,486CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$44,767,924CurrentTaxYearMinus1YearAmt
Current Tax Year$45,528,665CurrentTaxYearAmt
Total$208,554,707TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$10,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,000CurrentTaxYearMinus2YearsAmt
Total$15,000TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$10,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,000CurrentTaxYearMinus2YearsAmt
Total$15,000TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$208,539,707PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,548,314CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$633,291CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$632,097CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$632,124CurrentTaxYearMinus1YearAmt
Current Tax Year$816,333CurrentTaxYearAmt
Total$5,262,159TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,284CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,487CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,482CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$834CurrentTaxYearMinus1YearAmt
Current Tax Year$26,013CurrentTaxYearAmt
Total$31,100TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,549,598CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$634,778CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$633,579CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$632,958CurrentTaxYearMinus1YearAmt
Current Tax Year$842,346CurrentTaxYearAmt
Total$5,293,259TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$31,316CurrentTaxYearMinus4YearsAmt
Total$31,316TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,644,453CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$38,676,871CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$43,786,065CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$45,400,882CurrentTaxYearMinus1YearAmt
Current Tax Year$46,371,011CurrentTaxYearAmt
Total$213,879,282TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97503PublicSupportCY509Pct
Public Support PY5090.96500PublicSupportPY509Pct
Investment Income CY0.02475InvestmentIncomeCYPct
Investment Income PY0.03450InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$1,414OtherActivitiesAmt
Total Lobbying Expenditures$1,414TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, QUESTION 1IFormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES THE ORGANIZATION PAYS ANNUAL DUES TO THE MISSOURI HEALTH CARE ASSOCIATION (MHCA) AND THE AMERICAN HEALTH CARE ASSOCIATION (AHCA). A PORTION OF THESE DUES ARE ALLOCABLE TO LOBBYING: $858 MHCA AND $556 AHCA.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,094,610OtherCostOrOtherBasisAmt
Book Value$4,094,610BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$48,549,582OtherCostOrOtherBasisAmt
Depreciation$25,584,450DepreciationAmt
Book Value$22,965,132BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$257,510OtherCostOrOtherBasisAmt
Depreciation$135,702DepreciationAmt
Book Value$121,808BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,590,911OtherCostOrOtherBasisAmt
Depreciation$4,000,226DepreciationAmt
Book Value$3,590,685BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,192,123OtherCostOrOtherBasisAmt
Depreciation$1,155,196DepreciationAmt
Book Value$1,036,927BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$31,809,162TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO RELATED PARTYDesc
Amt$564,579Amt
FieldValueIRS element (for citing)
Total Liability$564,579TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$45,952,561TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$8,285NetUnrealizedGainsInvstAmt
Other Revenue$25,232OtherRevenueAmt
Revenue Not Reported$16,947RevenueNotReportedAmt
Revenue Subtotal$45,935,614RevenueSubtotalAmt
Other Revenues Not Included$476,910OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$476,910RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$46,412,524TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$44,542,966TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$377,979OtherExpensesIncludedAmt
Expenses Not Reported-$377,979ExpensesNotReportedAmt
Expenses Subtotal$44,920,945ExpensesSubtotalAmt
Other Expenses Not Included$103,434OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$103,434ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$45,024,379TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART IV, LINE 2BESCROW ACCOUNT LIABILITY: THE FOUNDATION WAS THE TRUSTEE OF $45,072 AND $47,727, RESPECTIVELY, AT MAY 31, 2016 AND 2015, IN FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS. THE FOUNDATION HAS FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THE BANK ACCOUNTS AND THE DISTRIBUTION OF THE FUNDS TO RESIDENTS.
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (103,434) SCHOLARSHIPS GRANTED 103,434 NET ASSETS RELEASED FROM RESTRICTION 25,232 CHANGE IN EQUITY INVESTMENT ----------- $ 25,232 TOTAL
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 885,484 GAIN ON SALE OF FIXED ASSETS (378,638) RENTAL EXPENSE (128,867) SPECIAL EVENT EXPENSE 22,709 SCHOLARSHIPS REFUNDED 30,645 TEMPORARILY RESTRICTED INVESTMENT INCOME 45,577 TEMPORARILY RESTRICTED CONTRIBUTIONS ----------- $ 476,910 TOTAL
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ (885,484) GAIN ON SALE OF FIXED ASSETS 378,638 RENTAL EXPENSE 128,867 SPECIAL EVENT EXPENSE ----------- $ (377,979) TOTAL
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 103,434 SCHOLARSHIPS GRANTED

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BURGUNDY BALLEvent1Nm
Gross Receipts Event1$76,402GrossReceiptsEvent1Amt
Charitable Contri Event1$46,600CharitableContriEvent1Amt
Gross Revenue Event1$29,802GrossRevenueEvent1Amt
Rent Facility Costs Event1$5,455RentFacilityCostsEvent1Amt
Food And Beverage Event1$41,346FoodAndBeverageEvent1Amt
Entertainment Event1$20,500EntertainmentEvent1Amt
Other Direct Expenses Event1$61,566OtherDirectExpensesEvent1Amt
Event2GOLF TOURNAMENTEvent2Nm
Gross Receipts Event2$47,713GrossReceiptsEvent2Amt
Charitable Contri Event2$38,977CharitableContriEvent2Amt
Gross Revenue Event2$8,736GrossRevenueEvent2Amt
Cash Prizes Event2$920CashPrizesEvent2Amt
Non Cash Prizes Event2$16,576NonCashPrizesEvent2Amt
Rent Facility Costs Event2$8,736RentFacilityCostsEvent2Amt
Food And Beverage Event2$3,436FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$8,747OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$124,115GrossReceiptsTotalAmt
Charitable Contributions Tot$85,577CharitableContributionsTotAmt
Gross Revenue Total Events$38,538GrossRevenueTotalEventsAmt
Cash Prizes Total Events$920CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$16,576NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$14,191RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$44,782FoodAndBeverageTotalEventsAmt
Entertainment Total Events$20,500EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$70,313OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$167,282DirectExpenseSummaryEventsAmt
Net Income Summary-$128,744NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
VARIOUS SCHOLARHIPS AWARDED41$73,630
CANCER PATIENT ASSISTANCE55$29,804

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2 & PART III, LINE 1FormAndLineReferenceDesc
ExplanationGRANT MONITORING: CITIZENS MEMORIAL HEALTH CARE FOUNDATION HAS A MEDICAL EXCELLENCE SCHOLARSHIP COMMITTEE MADE UP OF BOARD MEMBERS, EMPLOYEES AND COMMUNITY MEMBERS. APPLICATIONS FOR THE SCHOLARSHIP MUST BE SUBMITTED EACH YEAR BY MARCH 1. THE COMMITTEE DETERMINES WHO THE SCHOLARSHIPS ARE AWARDED TO. IF THE AWARDED DOES NOT ENROLL IN A MEDICAL RELATED CLASS TIMELY, THE SCHOLARSHIP IS WITHDRAWN. MANY OF THE PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL AND NOT THE INDIVIDUAL.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
DONALD J BABB
EXECUTIVE DIRECTOR$108,700$346,321$38,283$0$0$24,396$1,345$10,169$0$9,284$148,328$390,170
WILLIAM DONNELL
BOARD MEMBER/PHYSICIAN$1,200$198,558$0$112$0$861$0$1,778$0$6,961$1,200$208,270
GARY FULBRIGHT
BOARD TREASURER - NONVOTING$0$218,611$0$24,638$0$27,998$0$10,107$0$9,326$0$290,680
RENEE MEYER
DIRECTOR OF FINANCE$153,539$0$29,629$0$13,392$0$7,253$0$9,289$0$213,102$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1AHEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION PAYS ANNUAL DUES FOR A COUNTRY CLUB MEMBERSHIP FOR THE FOLLOWING INDIVIDUALS: $ 1,826 TIM FRANCKA $ 1,826 RENEE MEYER $ 1,826 KENNETH SCHANDA THESE AMOUNTS ARE INCLUDED IN THE EMPLOYEES W-2 AS TAXABLE WAGES.
SCHEDULE J, PART I, LINE 3CRITERIA TO ESTABLISH EXECUTIVE DIRECTOR COMPENSATION: THE FOUNDATION'S EXECUTIVE DIRECTOR, DONALD BABB, IS PAID THROUGH CITIZENS MEM HOSPITAL DISTRICT. AT THE DISTRICT LEVEL, HIS COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS USING COMPARABLE STATISTIC FOR SIMILAR POSITIONS IN THE HEALTHCARE INDUSTRY.
SCHEDULE J, PART I, LINE 6ACONTINGENT COMPENSATION: IN FY 2016, THE FOUNDATION'S BOARD APPROVED TO PAY OUT BONUSES AT 10% OF NET INCOME. THE BONUS IS ALLOCATED TO MANAGEMENT AND STAFF. DONALD BABB AND RENEE MEYER'S ALLOCATION OF THIS BONUS IS SHOWN IN SCHEDULE J, PART II, COLUMN B(II).

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
INDUSTRIAL DVLP AUTH OF DALLAS COUNTY
A4315468852014-02-25$5,940,000REFUND SERIES 2004 REV BONDSfalsefalsefalse
INDUSTRIAL DVLP AUTH OF THE CITY OF ELDORDO SPRGS
B2600251152012-01-27$2,680,000REFUND SERIES 2001 REV BONDSfalsefalsefalse
INDUSTRIAL DVLP AUTH OF POLK COUNTY
C0109128052014-02-25$6,385,000REFUND SERIES 2004 REV BONDS/ACQUIfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$0$0$5,940,000$0$0$0$0$0$0$5,940,000$0$02014Yes (true)falseYes (true)Yes (true)
B$0$0$2,680,000$0$0$0$0$0$0$2,680,000$0$02012Yes (true)falseYes (true)Yes (true)
C$0$0$6,385,000$0$0$0$0$0$0$6,385,000$0$02014Yes (true)falseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
Afalsefalsefalsefalse0falsefalsefalseYes (true)
B0
Cfalsefalsefalsefalse0falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
AfalseYes (true)falsefalsefalsefalsefalse0falsefalse
0
BfalseYes (true)falsefalsefalsefalsefalse0falsefalse
0
CfalseYes (true)falsefalsefalsefalsefalse0falsefalse

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)
CYes (true)

Schedule N IRS990ScheduleN

FieldValueIRS element (for citing)
Liquidation Of Assets TableLiquidationOfAssetsTableGrp

Disposition Of Assets Detail DispositionOfAssetsDetail (4 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
BOLIVAR MEDICAL BUILDING
LAND, BUILDINGS, EQUIPMENT2016-05-27$3,471,709BOOK VALUE2627976361500 N OAKLAND AVEBOLIVARMO65613LLC
CMH PROPERTIES
LAND, BUILDINGS, EQUIPMENT2016-05-27$27,570,876BOOK VALUE4636455901500 N OAKLAND AVEBOLIVARMO65613501(C)(3)
BOLIVAR MEDICAL BUILDING
TRANSACTION EXPENSES2016-05-27$5,907BOOK VALUE2627976361500 N OAKLAND AVEBOLIVARMO65613LLC
CMH PROPERTIES
TRANSACTION EXPENSES2016-05-27$32,815BOOK VALUE4636455901500 N OAKLAND AVEBOLIVARMO65613501(C)(3)
FieldValueIRS element (for citing)
Director Of Successor2Yes (true)DirectorOfSuccessor2Ind
Employee Of Successor2falseEmployeeOfSuccessor2Ind
Owner Of Successor2falseOwnerOfSuccessor2Ind
Receive Compensation2falseReceiveCompensation2Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE N, PART II, LINE 1LIABILITIES REPAID FROM SALE OF PROPERTIES: THE FOLLOWING LIABILITIES WERE REPAID FROM THE PROCEEDS OF THE SETTLEMENT AGREEMENTS WITH CMH PROPERTIES AND BOLIVAR MEDICAL BUILDING, LLC. -PAYOFF BOND SERIES 2001, 2008 AND 2009 OF APPROXIMATELY $10,500,000 -PAYOFF NOTES PAYABLE OF APPROXIMATELY $22,322,000 -TRANSACTION EXPENSES OF $38,722
SCHEDULE N, PART II, LINE 2ADIRECTORS OF THE PURCHASING ENTITY: CMH PROPERTIES HAS AN IDENTICAL BOARD TO CMHCF. ALL THREE OFFICERS OF CMHCF ALSO SERVE AS OFFICERS OF CMH PROPERTIES.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1ORGANIZATION'S MISSION: THE ORGANIZATION WAS CREATED TO SUPPORT CMH HOSPITAL DISTRICT THROUGH LONG TERM CARE SERVICES SUCH AS SKILLED NURSING FACILITIES, RESIDENTIAL CARE FACILITIES AND INDEPENDENT LIVING APARTMENTS, AND TO PROVIDE SERVICES TO THE LOCAL RURAL COMMUNITIES SUCH AS MEDICAL EQUIPMENT AND SUPPLIES, HOME HEALTH AND HOSPICE, HEALTH TRANSPORTATION AND HOMEMAKER CHORE SERVICES.
FORM 990, PART I, LINE 6NUMBER OF VOLUNTEERS: THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS ALONG WITH OTHER AUXILIARY VOLUNTEERS WHO ASSIST WITH A VARIETY OF OPPORTUNITIES AT THE FOUNDATION'S FACILITIES.
FORM 990, PART III, LINE 3SIGNIFICANT CHANGES TO PROGRAM SERVICES: IN FISCAL YEAR 2016, CITIZENS MEMORIAL HEALTH CARE FOUNDATION (CMHCF) SOLD BOLIVER TECHNICAL COLLEGE (BTC) TO CMH PROPERTIES. ADDITIONALLY IN FISCAL YEAR 2016, CMHCF SOLD A PORTION OF THE MEDICAL CENTER TO BOLIVAR MEDICAL BUILDING (BMB) AND THE REMAINDER TO CMH PROPERTIES.
FORM 990, PART III, LINE 4A, 4B, 4C & 4DPROGRAM SERVICE ACTIVITY DETAIL: WE OFFER CARE AT EVERY STAGE OF LIFE BY PROVIDING HOME CARE, INDEPENDENT LIVING, RESIDENTIAL CARE AND SKILLED NURSING (LONG TERM CARE) FACILITIES. ALL FACILITIES OFFER RESIDENT AND FAMILY SERVICES INCLUDING SOCIAL SERVICES; DAILY ACTIVITIES AND MONTHLY OUTINGS; BEAUTY AND BARBER SERVICES; VISITS FROM COMMUNITY AND SCHOOL ORGANIZATIONS; AND LAUNDRY, CHURCH AND PHARMACY SERVICES. MONTHLY FAMILY SUPPORT GROUPS AND RESIDENT CARE PLANNING MEETINGS ASSIST FAMILY MEMBERS WITH EDUCATION AND RESOURCES TO ENHANCE THE QUALITY OF TIME SHARED WITH LOVED ONES. IN ADDITION, IF PATIENTS NEED A LITTLE EXTRA HELP, HOMEMAKER PLUS CAN HELP THEM REMAIN INDEPENDENT IN THEIR HOME. OUR SERVICES ARE PROVIDED ON A NONDISCRIMINATORY BASIS AND CAN BENEFIT EVERYONE, FROM THE ELDERLY AND PHYSICALLY CHALLENGED TO THE HEALTHY FAMILY ON THE GO. A CARING INDIVIDUAL WILL VISIT THE HOME AND ASSIST PATIENTS ON A LONG-TERM OR ONE-TIME BASIS WITH SKILLED NURSING, REHABILITATIVE SERVICES, HOUSEKEEPING CHORES, MEAL PLANNING, GROCERY SHOPPING AND A HOST OF OTHER IMPORTANT SERVICES. SHOPPING AND A HOST OF OTHER IMPORTANT SERVICES.
FORM 990, PART VI, SECTION A, LINE 2BOARD MEMBER BUSINESS RELATIONSHIP: BOARD MEMBERS BRAD GREGORY AND DAVE STRADER HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11B990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 WILL BE REVIEWED BY TOP MANAGEMENT. AFTER MANAGEMENT'S REVIEW, A COPY OF THE 990 WILL BE PROVIDED TO THE BOARD FOR THEIR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CMONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY REVIEW: ANNUALLY, DURING THE MARCH BOARD OF DIRECTOR'S MEETING, THE OFFICERS AND DIRECTORS DISCLOSE ALL KNOWN CONFLICTS OF INTEREST. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. IN ADDITION, ALL CORPORATE OFFICERS AND KEY EMPLOYEES ARE ANNUALLY REQUIRED TO REPORT POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION REVIEW POLICY: THE BOARD OF DIRECTORS OF CITIZENS MEMORIAL HOSPITAL DISTRICT ESTABLISHES THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER/EXECUTIVE DIRECTOR BASED UPON COMPENSATION FOR SIMILAR POSITIONS IN THE HEALTHCARE INDUSTRY. A WRITTEN EMPLOYMENT AGREEMENT DETAILS THE SALARY AND BENEFITS FOR THE CEO/EXECUTIVE DIRECTOR. CITIZENS MEMORIAL HEALTH CARE FOUNDATION PAYS A PERCENTAGE OF THE TOTAL BASED UPON THE ESTIMATED PERCENTAGE OF TIME SPLIT BETWEEN THE TWO ORGANIZATIONS. THIS PERCENTAGE IS NOT ANNUALLY REVIEWED OR APPROVED BY THE CITIZENS MEMORIAL HOSPITAL DISTRICT BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT DISCLOSURE: MANY ORGANIZATION POLICIES ARE MADE AVAILABLE TO EMPLOYEES ON THE COMPANY INTRANET, FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST TO ALL BONDHOLDERS FOR A LEGITIMATE BUSINESS PURPOSE, AND THE AUDIT REPORT IS MADE AVAILABLE TO ALL LENDERS. IN GENERAL, DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC BY ANY OTHER MEANS.
FORM 990, PART VII, SECTION ABOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. DONALD J BABB RECEIVES COMPENSATION FROM CITIZENS MEMORIAL HEALTH CARE FOUNDATION FOR HIS ROLE AS EXECUTIVE DIRECTOR. WILLIAM DONNELL IS COMPENSATED BY THE ORGANIZATION FOR SERVING AS MEDICAL DIRECTOR FOR A SKILLED NURSING FACILITY AND IS COMPENSATED BY CITIZENS MEMORIAL HOSPITAL, A RELATED ORGANIZATION, AS A PHYSICIAN.
FORM 990, PART IX, LINE 11AMANAGEMENT FEES: MANAGEMENT FEES REPORTED ON LINE 11A REPRESENTS THE FOUNDATION'S PORTION OF EXPENSES RELATING TO DEPARTMENTS SHARED WITH CITIZENS MEMORIAL HOSPITAL, A RELATED PARTY. AT NO POINT DURING THE YEAR DID THE FOUNDATION DELEGATE MANAGERIAL DUTIES TO THE HOSPITAL.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: $25,232 CHANGE IN EQUITY INVESTMENTS

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CITIZENS MEMORIAL HOSPITAL
1500 N OAKLANDBOLIVARMO65613431142176HOSPITALMO501(C)(3)3NAfalse
RIVERSIDE MANAGEMENT AND REHABILITATION
1500 N OAKLANDBOLIVARMO65613431776752MGT AND REHABMO501(C)(3)9CMHfalse
CMH PROPERTIES
1500 N OAKLANDBOLIVARMO65613463645590RE HOLDINGSMO501(C)(3)11BIICMHCFYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BOLIVAR MED BLDG LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11500 N OAKLANDAddressLine1Txt
CityBOLIVARCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65613ZIPCd
FieldValueIRS element (for citing)
EIN262797636EIN
Primary ActivitiesMEDICAL BLDGPrimaryActivitiesTxt
Legal Domicile StateMOLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CMHCFBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeEXCLUDED FROM TAXPredominantIncomeTypeTxt
Share Of Total Income$24,488ShareOfTotalIncomeAmt
Share Of EOY Assets$349,664ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.51000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgYes (true)AssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
BOLIVAR MEDICAL BUIDLING LLC
J$98,289FMV
BOLIVAR MEDICAL BUILDING LLC
G$3,471,709FMV
CMH PROPERTIES
G$27,570,876FMV