PHELPS COUNTY HOSPITAL FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- PHELPS COUNTY HOSPITAL FOUNDATION (EIN 43-1696258)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-15
- IRS object ID
- 201732279349302518
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-15T13:12:27-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431696258 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS COUNTY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JANA COOK | InCareOfNm |
| Business Name Control | PHEL | BusinessNameControlTxt |
| Phone | 5733648899 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 WEST 10TH STREET | AddressLine1Txt |
| City | ROLLA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWARD CLAYTON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2017-04-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EDWARD CLAYTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 WEST 10TH STREET | AddressLine1Txt |
| City | ROLLA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $940,697 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PCRMC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | SERVES AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST PCRMC IN PROVIDING HEALTHCARE. SEE SCHEDULE O FOR MORE DETAIL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 10 | TotalEmployeeCnt |
| Total Volunteers | 36 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,204,433 | PYContributionsGrantsAmt |
| CY Contributions Grants | $882,236 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,096 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,375 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$11,385 | PYOtherRevenueAmt |
| CY Other Revenue | -$26,156 | CYOtherRevenueAmt |
| PY Total Revenue | $1,194,144 | PYTotalRevenueAmt |
| CY Total Revenue | $857,455 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $104,204 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $84,624 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $529,378 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $517,724 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $2,595 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $69,541 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $187,828 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $324,117 | PYOtherExpensesAmt |
| CY Other Expenses | $208,351 | CYOtherExpensesAmt |
| PY Total Expenses | $960,294 | PYTotalExpensesAmt |
| CY Total Expenses | $880,240 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $233,850 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$22,785 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,767,388 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,338,102 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,779,740 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,360,310 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$12,352 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$22,208 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION IS TO SERVE AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST THE MISSIONS OF PHELPS COUNTY REGIONAL MEDICAL CENTER IN PROVIDING FOR THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $564,804 | ExpenseAmt |
| Grant | $84,624 | GrantAmt |
| Desc | THE ORGANIZATION FACILITATES CHARITABLE DONATIONS TO HELP SUPPORT THE MISSIONS AND ACTIVITIES OF PHELPS COUNTY REGIONAL MEDICAL CENTER. CONTRIBUTIONS ARE RECEIVED BY THE ORGANIZATION AND DISTRIBUTED TO PCRMC FOR USE IN ITS MISSION TO PROVIDE FOR THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. | Desc |
| Total Program Service Expenses | $564,804 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | 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 | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | 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 | Yes (true) | 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 | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 10 | 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 | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANA COOK | PersonNm |
| Phone | 5734587916 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 WEST 10TH STREET | AddressLine1Txt |
| City | ROLLA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|
| JOHN DENBO | |||||||
| CEO/MEMBER END 01/16 | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $327,260 | $25,689 |
| TED DAY | |||||||
| TREASURER END 01/16; PRESIDENT | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PATRICIA LEADERS | |||||||
| SECRETARY | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LORRIE HARTLEY | |||||||
| DIRECTOR | 1.0 | 40.0 | Yes (X) | $0 | $147,264 | $26,967 | |
| CANDACE CONNELL | |||||||
| PRESIDENT END 01/16; MEMBER | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CINDY BEGER | |||||||
| VICE PRES. END 01/16; MEMBER | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| OLLIE JACKSON | |||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| SAMMY AUXIER JR | |||||||
| MEMBER; TREASURER BEG 01/16 | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LINDA MITCHELL | |||||||
| MEMBER END 08/16 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| EDWARD CLAYTON | |||||||
| MEMBER/CEO BEG 01/16 | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $259,333 | $38,963 |
| AMY MEADOWS | |||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| JEFF SCHRADER | |||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| MOLLY MALONE | |||||||
| MEMBER END 01/16 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| SHAD BECKER | |||||||
| MEMBER END 01/16 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| WALT BRANSON | |||||||
| MEMBER; VICE PRES. BEG 01/16 | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STEVE LYNCH | |||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| SANDY MITCHELL | |||||||
| MEMBER END 01/16 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| DR LEROY WOMBOLD | |||||||
| MEMBER END 08/16 | 1.0 | 40.0 | Yes (X) | $0 | $399,128 | $34,722 | |
| KERI BROOKSHIRE-HEAVIN | |||||||
| MEMBER | 1.0 | 40.0 | Yes (X) | $0 | $166,267 | $28,122 | |
| DR CHRISTOPHER SPENCER | |||||||
| MEMBER | 1.0 | 40.0 | Yes (X) | $0 | $360,955 | $9,411 | |
| JASON SHENEFIELD | |||||||
| COO/MEMBER BEG 08/16 | 1.0 | 40.0 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,660,207 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $163,874 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $290,805 | FundraisingAmt |
| Related Organizations | $31,384 | RelatedOrganizationsAmt |
| All Other Contributions | $560,047 | AllOtherContributionsAmt |
| Noncash Contributions | $42,610 | NoncashContributionsAmt |
| Total Contributions | $882,236 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,375 | TotalRevenueColumnAmt |
| Exclusion | $1,375 | 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 | $57,086 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $290,805 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $83,242 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$26,156 | TotalRevenueColumnAmt |
| Exclusion | -$26,156 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $857,455 | TotalRevenueColumnAmt |
| Exclusion | -$24,781 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,624 | TotalAmt |
| Program Services | $84,624 | 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 | $388,326 | TotalAmt |
| Program Services | $267,550 | ProgramServicesAmt |
| Management And General | $58,783 | ManagementAndGeneralAmt |
| Fundraising | $61,993 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,785 | TotalAmt |
| Program Services | $9,497 | ProgramServicesAmt |
| Management And General | $2,087 | ManagementAndGeneralAmt |
| Fundraising | $2,201 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,431 | TotalAmt |
| Program Services | $62,305 | ProgramServicesAmt |
| Management And General | $13,689 | ManagementAndGeneralAmt |
| Fundraising | $14,437 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,182 | TotalAmt |
| Program Services | $17,350 | ProgramServicesAmt |
| Management And General | $3,812 | ManagementAndGeneralAmt |
| Fundraising | $4,020 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,990 | TotalAmt |
| Management And General | $2,990 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,541 | TotalAmt |
| Fundraising | $69,541 | FundraisingAmt |
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 | $5,764 | TotalAmt |
| Program Services | $5,764 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,068 | TotalAmt |
| Program Services | $6,120 | ProgramServicesAmt |
| Management And General | $24,948 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,071 | TotalAmt |
| Program Services | $71,780 | ProgramServicesAmt |
| Management And General | $12,291 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,354 | TotalAmt |
| Fundraising | $33,354 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,744 | TotalAmt |
| Program Services | $1,744 | ProgramServicesAmt |
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 | $21,052 | TotalAmt |
| Program Services | $14,207 | ProgramServicesAmt |
| Management And General | $6,845 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,923 | TotalAmt |
| Program Services | $5,459 | ProgramServicesAmt |
| Management And General | $1,199 | ManagementAndGeneralAmt |
| Fundraising | $1,265 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| LICENSES, DUES, SUBSCRIPTIONS | $12,518 | $12,518 | ||
| MISCELLANEOUS EXPENSES | $7,867 | $5,886 | $964 | $1,017 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $880,240 | TotalAmt |
| Program Services | $564,804 | ProgramServicesAmt |
| Management And General | $127,608 | ManagementAndGeneralAmt |
| Fundraising | $187,828 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,537,928 | BOYAmt |
| EOY | $3,120,140 | 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 | $40,000 | BOYAmt |
| EOY | $3,400 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,659 | BOYAmt |
| EOY | $41,085 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $70,962 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $46,790 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,166 | BOYAmt |
| EOY | $24,172 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,635 | BOYAmt |
| EOY | $149,305 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,767,388 | BOYAmt |
| EOY | $3,338,102 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,324 | BOYAmt |
| EOY | $8,448 | 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 | $19,617 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,743,799 | BOYAmt |
| EOY | $3,351,862 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,779,740 | BOYAmt |
| EOY | $3,360,310 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,352 | BOYAmt |
| EOY | -$22,208 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,352 | BOYAmt |
| EOY | -$22,208 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,767,388 | BOYAmt |
| EOY | $3,338,102 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$22,785 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $12,929 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PCRMC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 436004435 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $84,500 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $84,500 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (true) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (true) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | false | SupportedOrgVoiceInvestmentInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Sch A Type3 Func Int | Form990SchAType3FuncIntGrp |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART I, LINE 11H, COLUMN I | NAME OF SUPPORTED ORGANIZATION: THE FULL NAME OF THE SUPPORTED ORGANIZATION IS PHELPS COUNTY REGIONAL MEDICAL CENTER. |
| SCHEDULE A, PART IV, SECTION E, LINE 1C | SUPPORT OF A GOVERNMENTAL ENTITY: PHELPS COUNTY HOSPITAL FOUNDATION SUPPORTS PHELPS COUNTY REGIONAL MEDICAL CENTER (PCRMC), A GOVERNMENTAL ENTITY. THE PURPOSE OF THE FOUNDATION IS TO SERVE AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST THE MISSION OF PCRMC IN PROVIDING HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THROUGH PATIENT-CENTERED AND COMMUNITY-FOCUSED INITIATIVES, THE FOUNDATION WORKS IN COOPERATION WITH CLINICIANS, STAFF, PATIENTS, FRIENDS AND DONORS TO ENSURE THE GREATEST NEEDS AND OPPORTUNITIES ARE FUNDED ACROSS PCRMC. |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,500 | OtherCostOrOtherBasisAmt |
| Book Value | $17,500 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,462 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,790 | DepreciationAmt |
| Book Value | $6,672 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $24,172 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO PCRMC | Desc |
| Amt | $3,351,862 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,351,862 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (3 entries)
| ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Retained By ContractorRetainedByContractorAmt |
|---|---|---|
| DIANE BLUMENSON | ||
| CAMPAIGN | false | $20,500 |
| ANN THOMPSON | ||
| CAMPAIGN | false | $11,646 |
| RISING TIDE DIRECT | ||
| CAMPAIGN | false | $31,875 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $64,021 | TotalRetainedByContractorsAmt |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CANCER GALA | Event1Nm |
| Gross Receipts Event1 | $191,557 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $155,401 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $36,156 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $3,240 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,510 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $25,274 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $6,609 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $4,743 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNEY | Event2Nm |
| Gross Receipts Event2 | $120,600 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $106,170 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $14,430 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $9,443 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $12,549 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $8,190 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $3,729 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $35,734 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $29,234 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $6,500 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $500 | NonCashPrizesOtherEventsAmt |
| Food And Beverage Other Events | $4,870 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $2,585 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $347,891 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $290,805 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $57,086 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $13,183 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $14,059 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $38,334 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $6,609 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $11,057 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $83,242 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$26,156 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS COUNTY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 W 10TH STREET | AddressLine1Txt |
| City | ROLLA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 436004435 | RecipientEIN |
| IRC Section | PHELPS CO RMC | IRCSectionDesc |
| Cash Grant | $84,500 | CashGrantAmt |
| Purpose Of Grant | SUPPORT PROGRAMS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING OF GRANT FUNDS: GRANTS ARE PROVIDED TO A RELATED ORGANIZATION AS PART OF THE FOUNDATION'S MISSION. GRANT SPENDING IS MONITORED MONTHLY BY PCRMC ACCOUNTING DEPARTMENT AND FINANCIAL INFORMATION IS FORWARDED TO DIRECTOR OF FOUNDATION TO DETERMINE IF ADDITIONAL GRANT FUNDS ARE NEEDED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN DENBO | ||||||||||||||
| CEO/MEMBER END 01/16 | $0 | $284,550 | $0 | $102 | $0 | $42,608 | $0 | $15,900 | $0 | $9,789 | $0 | $352,949 | $0 | $0 |
| LORRIE HARTLEY | ||||||||||||||
| DIRECTOR | $0 | $139,109 | $0 | $102 | $0 | $8,053 | $0 | $9,158 | $0 | $17,809 | $0 | $174,231 | $0 | $0 |
| EDWARD CLAYTON | ||||||||||||||
| MEMBER/CEO BEG 01/16 | $0 | $238,712 | $0 | $102 | $0 | $20,519 | $0 | $15,900 | $0 | $23,063 | $0 | $298,296 | $0 | $0 |
| DR LEROY WOMBOLD | ||||||||||||||
| MEMBER END 08/16 | $0 | $331,306 | $0 | $43,102 | $0 | $24,720 | $0 | $15,900 | $0 | $18,822 | $0 | $433,850 | $0 | $0 |
| KERI BROOKSHIRE-HEAVIN | ||||||||||||||
| MEMBER | $0 | $163,607 | $0 | $101 | $0 | $2,559 | $0 | $10,313 | $0 | $17,809 | $0 | $194,389 | $0 | $0 |
| DR CHRISTOPHER SPENCER | ||||||||||||||
| MEMBER | $0 | $250,853 | $0 | $92,102 | $0 | $18,000 | $0 | $0 | $0 | $9,411 | $0 | $370,366 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION DETERMINATION: PHELPS COUNTY REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION, USES A WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE IN DETERMINING THE COMPENSATION OF THE CEO. | ExplanationTxt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $42,610 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp | |
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, LINE 9B | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTIONS OR ITEMS CONTRIBUTED: THE AMOUNT REPORTED IN COLUMN B IS THE NUMBER OF PERSONS WHO MADE NONCASH CONTRIBUTIONS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S SIGNIFICANT ACTIVITIES: THE PHELPS COUNTY REGIONAL HEALTH CARE FOUNDATION IS A 501(C)(3) NOT-FOR-PROFIT, PHILANTHROPIC ORGANIZATION THE WAS ESTABLISHED IN 1996. OUR MISSION IS TO SERVE AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST THE MISSION OF THE PHELPS COUNTY REGIONAL MEDICAL CENTER. THE FOUNDATION EXISTS TO ENSURE THAT HEALTH CARE DELIVERY IN PHELPS COUNTY AND THE SURROUNDING COMMUNITIES CONTINUES TO BE TRANSFORMATIONAL. THROUGH PATIENT-CENTERED AND COMMUNITY-FOCUSED INITIATIVES, THE FOUNDATION WORKS IN COOPERATION WITH CLINICIANS, STAFF, PATIENTS, FRIENDS AND DONORS TO ENSURE THE GREATEST NEEDS AND OPPORTUNITIES ARE FUNDED ACROSS PHELPS COUNTY REGIONAL MEDICAL CENTER. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: FORMERLY, THE CFO & CHIEF OF STAFF OF THE PHELPS COUNTY REGIONAL MEDICAL CENTER, AND THE AUXILIARY BOARD PRESIDENT WERE REQUIRED TO BE EX-OFFICIO MEMBERS OF THE PHELPS COUNTY HOSPITAL FOUNDATION BOARD. WITH THE AMENDMENT OF THE ORGANIZATION'S BYLAWS, THIS REQUIREMENT HAS BEEN REMOVED. IN ADDITION, THE CEO OF THE FOUNDATION CAN MAKE RECOMMENDATIONS OF HOSPITAL EMPLOYEES TO SERVE AS EX-OFFICIO MEMBER(S) OF THE BOARD WITH THE APPROVAL OF THE EXISTING BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INTERNAL FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM IS REVIEWED BY THE CFO AND CONTROLLER OF THE ORGANIZATION BEFORE BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: ALL EMPLOYEES, DIRECTORS, OFFICERS AND TRUSTEES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. EACH INDIVIDUAL IS REQUIRED TO SUBMIT ANY POTENTIAL CONFLICTS FOR REVIEW BY THE BOARD AND, IF NECESSARY, GENERAL COUNSEL SO THAT A DETERMINATION OF CONFLICT CAN BE ISSUED. IF A CONFLICT DOES EXIST, THE AFFECTED INDIVIDUAL IS NOT ALLOWED TO VOTE WITH REGARDS TO TRANSACTIONS THAT INVOLVE THE ORGANIZATION AND POTENTIALLY THE CONFLICTED PARTY AND WILL BE EXCUSED FROM THE BOARD SESSION DURING THE VOTING PERIOD. IN ADDITION, THE BOARD MAINTAINS THE RIGHT TO APPOINT AN INDEPENDENT THIRD PARTY TO RESEARCH THE POTENTIAL TRANSACTION AND ANY POSSIBLE ALTERNATIVES. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW: THE TOP MANAGEMENT OFFICIAL OF THE ORGANIZATION IS COMPENSATED BY PHELPS COUNTY REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION. HUMAN RESOURCES CONDUCTS AN ORGANIZATION-WIDE COMPENSATION REVIEW BASED ON MARKET DATA COLLECTED FROM COMPETITIVE MARKETS. RECOMMENDED ADJUSTMENTS ARE BASED ON THE DATA COLLECTED AND THE FINANCIAL POSITION OF THE ORGANIZATION. PAY RAISES ARE APPROVED BY THE BOARD OF DIRECTORS, AND DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: JOHN DENBO, EDWARD CLAYTON, DR. LEROY WOMBOLD, KERI BROOKSHIRE-HEAVIN, DR. CHRISTOPHER SPENCER, AND LORRIE HARTLEY RECEIVE W-2 COMPENSATION FROM PHELPS COUNTY REGIONAL MEDICAL CENTER FOR THEIR SERVICES AS EMPLOYEES. NO BOARD MEMBERS ARE COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS COUNTY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 W 10TH STREET | AddressLine1Txt |
| City | ROLLA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 436004435 | EIN |
| Primary Activities | HEALTH CARE | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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