NORTHWEST MEDICAL CENTER INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST MEDICAL CENTER INC (EIN 32-0453405)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201733199349313463
Schema version
2016v3.0
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)
Return2017-11-15T15:22:38-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN621532536PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COULTER & JUSTUS PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19717 COGDILL ROAD SUITE 201AddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37932ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN320453405EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone8652694074PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 LEINART STREETAddressLine1Txt
CityCLINTONCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37716ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIM BROWNPersonNm
Person TitleCHIEF ADMINISTRATIVE OFFICERPersonTitleTxt
Phone8652694074PhoneNum
Signature2017-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNAN C BOBBETT CPAPreparerPersonNm
PTINP00119087PTIN
Phone8656374161PhoneNum
Preparation2017-11-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address69.73.35.66IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-15IPDt
IP Tm16:04:21IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7A4EF9AC64FBE830EA58DFFC6973B2E648D048A7AtSubmissionCreationDeviceId
At Submission Filing Device IdB91E052758ECDDE3CAD1E49FCBF94DD950095196AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIM BROWNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 LEINART STREETAddressLine1Txt
CityCLINTONCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37716ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$25,757,811GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NORTHWESTMEDCENTER.NETWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2014FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionNORTHWEST MEDICAL CENTER, INC. SEEKS TO IMPROVE THE DELIVERY OF HEALTHCARE SERVICES IN RURAL AMERICA BY GIVING LOCAL HEALTHCARE ORGANIZATIONS AN ALTERNATIVE TO FOR-PROFIT HOSPITAL COMPANIES OR TERTIARY HEALTH SYSTEMS THAT VIEW RURAL HOSPITALS AS REFERRAL SOURCES AND WHICH ARE AGGRESSIVELY DIVESTING OR EVEN CLOSING DISTRESSED RURAL HOSPITALS. NORTHWEST MEDICAL CENTER HAS CREATED A NONPROFIT HEALTHCARE SYSTEM THAT FOCUSES ON STABILIZING RURAL HOSPITALS BY PROVIDING THEM WITH RURAL HEALTHCARE MANAGEMENT EXPERTISE AND MORE EFFICIENT LOW COST SERVICES THAT ARE TRADITIONALLY ONLY AVAILABLE THROUGH LARGER HEALTHCARE SYSTEMS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee223TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$23,667,636PYProgramServiceRevenueAmt
CY Program Service Revenue$25,001,013CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$147,502PYOtherRevenueAmt
CY Other Revenue$756,798CYOtherRevenueAmt
PY Total Revenue$23,815,138PYTotalRevenueAmt
CY Total Revenue$25,757,811CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,477,126PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,956,649CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,994,546PYOtherExpensesAmt
CY Other Expenses$15,824,342CYOtherExpensesAmt
PY Total Expenses$25,471,672PYTotalExpensesAmt
CY Total Expenses$27,780,991CYTotalExpensesAmt
PY Revenues Less Expenses-$1,656,534PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,023,180CYRevenuesLessExpensesAmt
Total Assets BOY$6,994,455TotalAssetsBOYAmt
Total Assets EOY$14,309,793TotalAssetsEOYAmt
Total Liabilities BOY$3,074,970TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,413,488TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,919,485NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,896,305NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionNORTHWEST MEDICAL CENTER, INC. SEEKS TO IMPROVE THE DELIVERY OF HEALTHCARE SERVICES IN RURAL AMERICA BY GIVING LOCAL HEALTHCARE ORGANIZATIONS AN ALTERNATIVE TO FOR-PROFIT HOSPITAL COMPANIES OR TERTIARY HEALTH SYSTEMS THAT VIEW RURAL HOSPITALS AS REFERRAL SOURCES AND WHICH ARE AGGRESSIVELY DIVESTING OR EVEN CLOSING DISTRESSED RURAL HOSPITALS. NORTHWEST MEDICAL CENTER HAS CREATED A NONPROFIT HEALTHCARE SYSTEM THAT FOCUSES ON STABILIZING RURAL HOSPITALS BY PROVIDING THEM WITH RURAL HEALTHCARE MANAGEMENT EXPERTISE AND MORE EFFICIENT LOW COST SERVICES THAT ARE TRADITIONALLY ONLY AVAILABLE THROUGH LARGER HEALTHCARE SYSTEMS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$19,682,447ExpenseAmt
Revenue$25,757,811RevenueAmt
DescTO IMPROVE THE DELIVERY OF HEALTHCARE SERVICES IN RURAL AMERICA BY GIVING LOCAL HEALTHCARE ORGANIZATIONS AN ALTERNATIVE TO FOR-PROFIT HOSPITAL COMPANIES OR TERTIARY HEALTH SYSTEMS THAT VIEW RURAL HOSPITALS AS REFERRAL SOURCES AND WHICH ARE AGGRESSIVELY DIVESTING OR EVEN CLOSING DISTRESSED RURAL HOSPITALS.Desc
Total Program Service Expenses$19,682,447TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document69IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee223EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEVE CLAPPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8652694074PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 LEINART STREETAddressLine1Txt
CityCLINTONCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37716ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
STEVE CLAPP
BOARD MEMBER0.000.00Yes (X)$0$0$0
DAVID CORBETT MD
CHIEF OF STAFF0.000.00Yes (X)$0$0$0
RANDY PRICE
BOARD MEMBER0.000.00Yes (X)$0$0$0
JAMES R MOSS MD
BOARD MEMBER0.000.00Yes (X)$0$0$0
BILL ATKINSON
BOARD MEMBER0.000.00Yes (X)$0$0$0
TOM MOORE
BOARD MEMBER0.000.00Yes (X)$0$0$0
DIANNA JUNKIN
BOARD MEMBER0.000.00Yes (X)$0$0$0
GERALD HUGHES
BOARD MEMBER0.000.00Yes (X)$0$0$0
JIM DICKINSON
CHAIRMAN0.000.00Yes (X)$0$0$0Yes (X)
RUSSELL CAROTHERS
VICE CHAIRMAN0.000.00Yes (X)$0$0$0Yes (X)
MICHAEL ARNO
SECRETARY0.000.00Yes (X)$0$0$0Yes (X)
MARTIN HAJJAR
PHYSICIAN0.0040.00$332,872$0$14,782Yes (X)
MARK RANDALL
PHYSICIAN0.0040.00$293,727$0$14,208Yes (X)
SRILAKSHMI SETTIPALLI
PHYSICIAN0.0033.00$182,275$0$1,123Yes (X)
MADHAV SONI
PHYSICIAN0.0040.00$269,502$0$8,262Yes (X)
JERILL THOMAS
PHYSICIAN0.0043.00$301,608$0$2,195Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,379,984TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$40,570TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DIVERSIFIED CLINICAL SERVICES
PO BOX 636981CINCINNATIOH45263WOUND CARE SERVICES$519,763
NORTHWEST ANESTHESIA INC
160 ROCKWELL STREETWINFIELDAL35594ANESTHESIOLOGIST SERVICES$452,119
ROBERT ADKINS
1591 CO HWY 61GUINAL35563CRNA SERVICES$220,000
HARRIS MEDICAL HOSPITALIST
68 HOSPITAL ROADSYLVANC28779ER PHYSICIAN AND HOSPITALIST SERVICES$189,558
PARALLON TECHNOLOGY SOLUTIONS
MSC 30225 PO BOX 41500NASHVILLETN37241BILLING, COLLECTIONS, AND IT$143,475
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE FEESDesc
Business624100BusinessCd
Total Revenue Column$25,001,013TotalRevenueColumnAmt
Related Or Exempt Func Income$25,001,013RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$25,001,013TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business900099BusinessCd
Total Revenue Column$756,798TotalRevenueColumnAmt
Related Or Exempt Func Income$756,798RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$756,798OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,757,811TotalRevenueColumnAmt
Related Or Exempt Func Income$25,757,811RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,379,984TotalAmt
Program Services$1,256,819ProgramServicesAmt
Management And General$123,165ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,611,406TotalAmt
Program Services$7,842,831ProgramServicesAmt
Management And General$768,575ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,965,259TotalAmt
Program Services$674,978ProgramServicesAmt
Management And General$1,290,281ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,214,881TotalAmt
Program Services$1,071,538ProgramServicesAmt
Management And General$143,343ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$332,567TotalAmt
Management And General$332,567ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$590,410TotalAmt
Management And General$590,410ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$261,684TotalAmt
Program Services$33,034ProgramServicesAmt
Management And General$228,650ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$3,814,377$3,770,865$43,512
CONTRACT SERVICES$3,127,937$1,530,357$1,597,580
PROFESSIONAL SERVICES$2,266,295$2,261,570$4,725
TAXES AND ASSESSMENTS$1,843,923$5,187$1,838,736

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,372,268TotalAmt
Program Services$1,235,268ProgramServicesAmt
Management And General$1,137,000ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$27,780,991TotalAmt
Program Services$19,682,447ProgramServicesAmt
Management And General$8,098,544ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$292,211BOYAmt
EOY$65,762EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,937,020BOYAmt
EOY$3,288,330EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$601,520BOYAmt
EOY$586,736EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$175,135BOYAmt
EOY$176,176EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,261,845LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$997,367LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,894,791BOYAmt
EOY$5,264,478EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$4,844,243EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$93,778BOYAmt
EOY$84,068EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,994,455BOYAmt
EOY$14,309,793EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$723,883BOYAmt
EOY$2,390,369EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,036,874BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,314,213BOYAmt
EOY$10,023,119EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,074,970BOYAmt
EOY$12,413,488EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,919,485BOYAmt
EOY$1,896,305EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,919,485BOYAmt
EOY$1,896,305EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,994,455BOYAmt
EOY$14,309,793EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,023,180ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$490,000OtherCostOrOtherBasisAmt
Book Value$490,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,744,277OtherCostOrOtherBasisAmt
Depreciation$87,692DepreciationAmt
Book Value$1,656,585BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,940,403OtherCostOrOtherBasisAmt
Depreciation$909,675DepreciationAmt
Book Value$3,030,728BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$87,165OtherCostOrOtherBasisAmt
Book Value$87,165BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,264,478TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED SALARIES AND BENEFITS$476,510
INTERCOMPANY PAYABLES$8,628,766
ESTIMATED THIRD-PARTY SETTLEMENTS$807,283
OTHER CURRENT LIABILITIES$110,560
FieldValueIRS element (for citing)
Total Liability$10,023,119TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$87,693TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$87,693NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,795,048TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,794,743DirectOffsettingRevenueAmt
Net Community Benefit Expns$305NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,882,741TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,794,743DirectOffsettingRevenueAmt
Net Community Benefit Expns$87,998NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,588TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,588NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,655TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,655NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,243TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,243NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,886,984TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,794,743DirectOffsettingRevenueAmt
Net Community Benefit Expns$92,241NetCommunityBenefitExpnsAmt
Total Expense0.00340TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$8,659,975BadDebtExpenseAmt
Bad Debt Expense Attributable$569,423BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,873,645ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,961,840CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$911,805MedicareSurplusOrShortfallAmt
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST MEDICAL CENTER INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11530 US HIGHWAY 43AddressLine1Txt
CityWINFIELDCityNm
State AbbreviationALStateAbbreviationCd
ZIP35594ZIPCd
FieldValueIRS element (for citing)
State LicenseH4701StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYYes (1)FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYYes (1)TaxExemptHospitalCYOrPYInd
CHNA Conducted0CHNAConductedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.NORTHWESTMEDCENTER.NETFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.NORTHWESTMEDCENTER.NETFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.NORTHWESTMEDCENTER.NETFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection Activities0CollectionActivitiesInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferenceNORTHWEST MEDICAL CENTER, INC.FormAndLineReferenceDesc
ExplanationPART V, SECTION B, LINE 20E: PROVIDED A WRITTEN NOTICE ABOUT UPCOMING ECAS (EXTRAORDINARY COLLECTION ACTION) AND A PLAIN LANGUAGE SUMMARY OF THE FAP AT LEAST 30 DAYS BEFORE INITATING THOSE ECAS; MADE A REASONABLE EFFORT TO ORALLY NOTIFY INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS; PROCESSED INCOMPLETE AND COMPLETE FAP APPLICATIONS.ExplanationTxt
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - NWMC-WINFIELD PHYSICIANS LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 LEINHART STAddressLine1Txt
CityCLINTONCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37716ZIPCd
FieldValueIRS element (for citing)
FacilityFAMILY MEDICINE PHYSICIAN FACILITYFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:N/A
PART 1, LINE 6AN/A
PART III, LINE 2:ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLETION EXPERIENCE.
PART III, LINE 3:ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLETION EXPERIENCE.
PART III, LINE 4:ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLETION EXPERIENCE.
PART III, LINE 8:AS A NON-PROFIT ORGANIZATION, THE HOSPITAL ACCEPTS ALL PATIENTS WITHOUT REGARD TO INSURANCE OR LACK OF INSURANCE OR ABILITY TO PAY.AMOUNTS BASED ON THE MEDICARE COST REPORT, WHICH IS PREPARED USING THE AUDITED TRIAL BALANCE. THE MEDICARE COST REPORT IS PREPARED IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGULATIONS.
PART III, LINE 9B:NORTHWEST MEDICAL CENTER OFFERS FINANCIAL ASSISTANCE THROUGH OUR CHARITY POLICY, BASED ON THE CURRENT FEDERAL POVERTY GUIDELINES (FPG), TO PATIENTS AND GUARANTORS. THOSE APPROVED FOR FINANCIAL ASSISTANCE ARE ELIGIBLE FOR DISCOUNTS APPLIED TO BALANCES OWED AFTER INSURANCE, AS WELL AS SELF-PAY BALANCES REMAINING AFTER OUR UNINSURED DISCOUNT IS APPLIED. IF THE PATIENT'S FAMILY INCOME IS BETWEEN 0%-200% OF THE FEDERAL POVERTY GUIDELINES, 100% DISCOUNT (CHARITY CARE). IF THE PATIENT'S FAMILY INCOME IS BETWEEN 201%-250% OF THE FEDERAL POVERTY GUIDELINES, 60% DISCOUNT (FINANCIAL ASSISTANCE). IF THE PATIENT'S FAMILY INCOME IS BETWEEN 251%-300% OF THE FEDERAL POVERTY GUIDELINES, 40% DISCOUNT (FINANCIAL ASSISTANCE). THIS POLICY IS PUBLICIZED IN PATIENT REGISTRATION AREAS, BILLING STATEMENTS AND IS AVAILABLE ON OUR WEB SITE. PATIENTS NOT ELIGIBLE FOR CHARITY OR WHO HAVE A BALANCE OWED AFTER THE APPLICATION OF CHARITY CARE OR UNINSURED DISCOUNT ARE SENT STATEMENTS AND/OR COLLECTION LETTERS AT LEAST EVERY 30 DAYS UNTIL THE BALANCE OWED IS PAID OR LONGER-TERM PAYMENT ARRANGEMENTS ARE MADE. ACCOUNTS THAT DO NOT HAVE SUFFICIENT PAYMENT ARRANGEMENTS ESTABLISHED ARE ELIGIBLE FOR OUTSIDE COLLECTIONS. ALL PATIENTS ARE NOTIFIED OF POSSIBLE COLLECTION ASSIGNMENT AT LEAST 30 DAYS BEFORE AN ASSIGNMENT IS MADE. IF A PATENT REQUESTS FINANCIAL ASSISTANCE AFTER STATEMENTS ARE SENT, THE ACCOUNT IS PLACED ON HOLD UNTIL A DETERMINATION OF ELIGIBILITY IS MADE.
PART VI, LINE 2:THE HOSPITAL PERFORMS OUTREACH SERVICES AND HEALTH EDUCATION OPPORTUNITIES FOR THE COMMUNITY. FEEDBACK FROM THESE EFFORTS ALONG WITH THE EVALUATION OF THE PATIENTS SERVED ARE CONSIDERED IN ASSESSING THE COMMUNITY'S HEALTH CARE NEEDS.
PART VI, LINE 3:INPATIENT SELF-PAY PATIENTS ARE SCREENED BY FINANCIAL COUNSELORS DURING THEIR STAY UPON APPLICATION BY THE PATIENT OR GUARANTOR. OUTPATIENT SERVICES ARE ALSO ELIGIBLE FOR FINANCIAL ASSISTANCE OR CHARITY UPON APPLICATION BY THE PATIENT OR GUARANTOR. SIGNAGE AT ALL REGISTRATION AREAS, MONTHLY STATEMENTS AND THE WEBSITE REFERENCE PHONE NUMBERS TO CALL FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:NORTHWEST MEDICAL CENTER PRIMARILY SERVES RESIDENTS OF WINFIELD, AL INCLUDING THE COUNTIES OF MARION AND FAYETTE. THIS IS A RURAL COMMUNITY WITH POPULATION BELOW 5,000 AND APPROXIMATELY 14% OF THE POPULATION BELOW THE POVERTY LINE. THE POPULATION IS PREDOMINANTLY CAUCASIAN, 92%, AS OF THE MOST RECENT CENSUS.
PART VI, LINE 5:THE HOSPITAL HAS A LOCAL BOARD OF VOLUNTEER COMMUNITY BOARD OF DIRECTORS AND IS SERVED BY AN OPEN MEDICAL STAFF. THE FACILITY IS ALSO SUPPORTED BY LOCAL VOLUNTEERS. THE HOSPITAL ACTIVELY RECRUITS PRIMARY CARE PHYSICIANS AND SPECIALISTS TO MEET MEDICAL NEEDS IN THE COMMUNITY. IN ADDITION, THE HOSPITAL PERFORMS OUTREACH SERVICES AND PROVIDES HEALTH EDUCATION OPPORTUNITIES FOR THE COMMUNITY.
PART VI, LINE 6:NORTHWEST MEDICAL CENTER IS PART OF CURAE HEALTH AND SERVES THE RESIDENTS OF WINFIELD, AL INCLUDING THE COUNTIES OF MARION AND FAYETTE.
PART VI, LINE 7, REPORTS FILED WITH STATESAL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARTIN HAJJAR
PHYSICIAN$332,872$0$0$0$0$0$3,517$0$11,265$0$347,654$0$0$0
MARK RANDALL
PHYSICIAN$293,727$0$0$0$0$0$2,423$0$11,785$0$307,935$0$0$0
SRILAKSHMI SETTIPALLI
PHYSICIAN$182,275$0$0$0$0$0$1,123$0$0$0$183,398$0$0$0
MADHAV SONI
PHYSICIAN$269,502$0$0$0$0$0$143$0$8,119$0$277,764$0$0$0
JERILL THOMAS
PHYSICIAN$301,608$0$0$0$0$0$835$0$1,360$0$303,803$0$0$0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonSTRATEGIC HEALTHCARE RESOURCES LLCPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionPRESIDENT IS THE SINGLE MEMBER OF STRATEGIC HEALTHCARE RESOURCES, LLCRelationshipDescriptionTxt
Transaction$720,691TransactionAmt
TransactionMANAGEMENT FEES ARE DETERMINED AT ARMS-LENGTH AND ARE AT COMMERICALLY REASONABLE RATESTransactionDesc
Sharing Of RevenuesYes (1)SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3NORTHWEST MEDICAL CENTER, INC. ENGAGES A MANAGEMENT COMPANY TO PROVIDE A FULL RANGE OF DAY-TO-DAY OPERATIONAL AND ADMINISTRATIVE SENIOR LEVEL MANAGEMENT SERVICES, INCLUDING THE APPOINTMENT OF MANAGEMENT PERSONNEL AT EACH OF THE HOSPITALS AND OTHER HEALTHCARE FACILITIES AND BUSINESS OF NORTHWEST MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FORM 990 WAS PROVIDED TO EACH BOARD MEMEBER. THE RETURN WAS REVIEWED PRIOR TO THE FILING OF THE TAX RETURN.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS DISCUSSED IN PERSON WITH EACH POTENTIAL BOARD MEMBER. WHEN MANAGEMENT BECOMES AWARE OF A POTENTIAL CONFLICT, IT IS DISCUSSED IN DEPTH WITH UPPER MANAGEMENT AND THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD VOTED ON ALL COMPENSATION AS PART OF THEIR ANNUAL BUDGET PROCESS, WHICH INCLUDES A REVIEW OF ALL POTENTIAL RAISES AND COMPARISON OF COMPARABLE COMPENSATION DATA.
FORM 990, PART VI, SECTION C, LINE 18DOCUMENTATION PROVIDED UPON REQUEST
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTATION PROVIDED UPON REQUEST
FORM 990, PART XII, LINE 2C:ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1NWMC-WINFIELD PHYSICIANS LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 LEINART STAddressLine1Txt
CityCLINTONCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37716ZIPCd
FieldValueIRS element (for citing)
EIN472498379EIN
Primary ActivitiesPROVIDE HEALTH CARE SERVICESPrimaryActivitiesTxt
Legal Domicile StateTNLegalDomicileStateCd
Total Income$2,493,860TotalIncomeAmt
End Of Year Assets$366,594EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST MEDICAL CENTER INCBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CURAE HEALTH INC
121 LEINART STREETCLINTONTN37716472275638HOSPITALTN501(C)(3)LINE 3N/AYes (1)
LAKELAND COMMUNITY HOSPITAL INC
121 LEINART STREETCLINTONTN37716472367677HOSPITALTN501(C)(3)LINE 3Yes (1)CURAE HEALTH INC
RUSSELLVILLE HOSPITAL INC
121 LEINART STREETCLINTONTN37716472378825HOSPITALTN501(C)(3)LINE 3Yes (1)CURAE HEALTH INC
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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