CULLMAN REGIONAL MEDICAL CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CULLMAN REGIONAL MEDICAL CENTER INC (EIN 63-1058174)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-02-07
- IRS object ID
- 201740389349300804
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-02-07T07:24:32-06:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 631058174 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULLMAN REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CULL | BusinessNameControlTxt |
| Phone | 2567372598 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1Txt |
| City | CULLMAN | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 350580609 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NESHA DONALDSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2567372595 | PhoneNum |
| Signature | 2017-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELINE G ATKINS | PreparerPersonNm |
| PTIN | P00861721 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2017-02-02 | PreparationDt |
| 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 | JAMES CLEMENTS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1Txt |
| City | CULLMAN | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 350580609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $113,122,989 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CRMCHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1939 | FormationYr |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Activity Or Mission | CULLMAN REGIONAL MEDICAL CENTER, LICENSED FOR 145 BEDS, OPERATES A 115-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF CULLMAN, ALABAMA AND SURROUNDING AREAS REGARDLESS OF A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1158 | TotalEmployeeCnt |
| Total Volunteers | 89 | TotalVolunteersCnt |
| Total Gross UBI | $1,317,918 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $44,775 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $834,973 | PYContributionsGrantsAmt |
| CY Contributions Grants | $530,636 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $95,688,771 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $106,740,195 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,413,843 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,343,421 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,014,551 | PYOtherRevenueAmt |
| CY Other Revenue | $4,498,171 | CYOtherRevenueAmt |
| PY Total Revenue | $102,952,138 | PYTotalRevenueAmt |
| CY Total Revenue | $113,112,423 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $76,800 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $76,800 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,612,842 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,224,260 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $51,250,610 | PYOtherExpensesAmt |
| CY Other Expenses | $51,502,871 | CYOtherExpensesAmt |
| PY Total Expenses | $95,940,252 | PYTotalExpensesAmt |
| CY Total Expenses | $100,803,931 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,011,886 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,308,492 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $112,551,392 | TotalAssetsBOYAmt |
| Total Assets EOY | $124,637,035 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $94,437,206 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $95,265,672 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,114,186 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,371,363 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CULLMAN REGIONAL MEDICAL CENTER, LICENSED FOR 145 BEDS, OPERATES A 115-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF CULLMAN, ALABAMA AND SURROUNDING AREAS REGARDLESS OF A PATIENT'S ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $88,756,230 | ExpenseAmt |
| Grant | $76,800 | GrantAmt |
| Revenue | $108,974,776 | RevenueAmt |
| Desc | CRMC PROVIDES ACUTE CARE PATIENT SERVICES WHICH ARE RENDERED TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. CRMC USES CHARITY APPLICATIONS BASED UPON FEDERAL POVERTY GUIDELINES AND FAMILY SIZE TO DETERMINE ELIGIBILITY FOLLOWING SERVICES PROVIDED. CRMC PROVIDES CARE 24 HOURS PER DAY, SEVEN DAYS A WEEK AND HAS PROVIDED 28,705 INPATIENT DAYS CARE, 6.3% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; 44,656 EMERGENCY ROOM VISITS, 21.13% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; AND 96,883 OUTPATIENT VISITS, 16.2% NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN. THE TOTAL UNREIMBUSED COST OF MEDICAL SERVICES PROVIDED TO THOSE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN IS REPORTED ON SCHEDULE H. CRMC ALSO PROVIDES COMMUNITY EDUCATION AND WELLNESS ACTIVITIES TO THE COMMUNITY AND IS A MAJOR CONTRIBUTOR TO A LOCAL INDIGENT CLINIC SERVICING CULLMAN COUNTY. | Desc |
| Total Program Service Expenses | $88,756,230 | 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 | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 222 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1158 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NESHA DONALDSON | PersonNm |
| Phone | 2567372598 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HWY 157 | AddressLine1Txt |
| City | CULLMAN | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 350580609 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAMES CLEMENTS | ||||||||
| CEO | 40.00 | 2.00 | Yes (X) | Yes (X) | $288,010 | $0 | $10,273 | |
| TODD MCLEROY | ||||||||
| PAST CHAIRMA | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JUDY BUTLER PATTERSON | ||||||||
| CHAIRMAN | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GREG BARKSDALE | ||||||||
| VICE CHAIRMA | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BETH ANDERSON | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LIONEL POWELL | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROGER HUMPHREY | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK BUSSMAN | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN DONALDSON | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DENNIS RICHARD | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BILLY FAULK | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| TYLER RODEN | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFF KROUT | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTOPHER COCCIA DO | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BILL SMITH MD | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CHERYL BAILEY | ||||||||
| CNO | 40.00 | 2.00 | Yes (X) | $154,271 | $0 | $6,185 | ||
| NESHA DONALDSON | ||||||||
| CFO | 40.00 | 1.00 | Yes (X) | $139,249 | $0 | $5,267 | ||
| JEFF STANLEY | ||||||||
| COO | 40.00 | Yes (X) | $102,058 | $0 | $0 | |||
| EDWARD MAHAN MD | ||||||||
| CARDIOLOGIST | 40.00 | $424,027 | $0 | $26,349 | Yes (X) | |||
| PAMELA JOHNSON-BROWN | ||||||||
| HR DIRECTOR | 40.00 | $133,267 | $0 | $7,227 | Yes (X) | |||
| CHARNA BROWN | ||||||||
| VP-QUALITY | 40.00 | $127,997 | $0 | $15,040 | Yes (X) | |||
| NANCY ZAVATCHEN | ||||||||
| IT DIRECTOR | 40.00 | $116,614 | $0 | $8,738 | Yes (X) | |||
| LORI MCGRATH | ||||||||
| CASE MGMT DI | 40.00 | $110,797 | $0 | $14,186 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,596,290 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $93,265 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDASSETS | |||||
| PO BOX 405652 | ATLANTA | GA | 303845652 | BUS OFC SVCS | $1,711,663 |
| CULLMAN ANESTHESIOLOGY & PAIN CONSUL | |||||
| PO BOX 1005 | CULLMAN | AL | 350561005 | CRNA SVCS | $1,560,000 |
| B E SMITH INTERIM SERVICES INC | |||||
| P O BOX 219241 | KANSAS CITY | MO | 641219241 | CONTRACT LABOR | $1,139,213 |
| CROTHALL HEALTHCARE INC | |||||
| 13028 COLLECTION CENTER DRIVE | CHICAGO | IL | 606930130 | ENVIRONMENTAL S | $931,043 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| PO BOX 636981 | CINCINNATI | OH | 452636981 | WOUND CARE SVC | $638,315 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 29 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $456,950 | RelatedOrganizationsAmt |
| Government Grants | $60,344 | GovernmentGrantsAmt |
| All Other Contributions | $13,342 | AllOtherContributionsAmt |
| Total Contributions | $530,636 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUES | 623000 | $105,422,277 | $105,422,277 | |
| CPAP MEDICAL EQUIPMENT | 621990 | $784,612 | $784,612 | |
| OUTREACH LAB SERVICES | 621500 | $466,213 | $466,213 | |
| CONFERENCE CENTER | 532000 | $44,300 | $44,300 | |
| SPORTS MEDICINE | 713940 | $22,793 | $22,793 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $106,740,195 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,333,828 | TotalRevenueColumnAmt |
| Exclusion | $1,333,828 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $266,863 | RealAmt |
| Personal | $233,318 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $266,863 | RealAmt |
| Personal | $233,318 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $500,181 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $233,318 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $266,863 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $20,159 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $10,566 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $9,593 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,593 | TotalRevenueColumnAmt |
| Exclusion | $9,593 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EMS MANAGEMENT FEES | 621910 | $2,677,546 | $2,677,546 | |
| CAFETERIA/CATERING | 722210 | $606,388 | $606,388 | |
| COMMUNITY SERVICE/EDUCATION | 624110 | $472,667 | $472,667 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $241,389 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $168,968 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $72,421 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,997,990 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $113,112,423 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $108,974,776 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,317,918 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,289,093 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,800 | TotalAmt |
| Program Services | $76,800 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $705,315 | TotalAmt |
| Management And General | $705,315 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,148,838 | TotalAmt |
| Program Services | $33,761,911 | ProgramServicesAmt |
| Management And General | $3,386,927 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,368,396 | TotalAmt |
| Program Services | $1,230,915 | ProgramServicesAmt |
| Management And General | $137,481 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,247,757 | TotalAmt |
| Program Services | $6,477,527 | ProgramServicesAmt |
| Management And General | $770,230 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,753,954 | TotalAmt |
| Program Services | $2,457,629 | ProgramServicesAmt |
| Management And General | $296,325 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,265,513 | TotalAmt |
| Program Services | $3,737,893 | ProgramServicesAmt |
| Management And General | $527,620 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,317 | TotalAmt |
| Management And General | $280,317 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,344 | TotalAmt |
| Management And General | $200,344 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,744 | TotalAmt |
| Management And General | $109,744 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,135,326 | TotalAmt |
| Program Services | $7,172,492 | ProgramServicesAmt |
| Management And General | $1,962,834 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $385,176 | TotalAmt |
| Program Services | $10,507 | ProgramServicesAmt |
| Management And General | $374,669 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,231,910 | TotalAmt |
| Program Services | $6,234,821 | ProgramServicesAmt |
| Management And General | $997,089 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,907 | TotalAmt |
| Management And General | $37,907 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,465,981 | TotalAmt |
| Program Services | $6,136,216 | ProgramServicesAmt |
| Management And General | $329,765 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $422,560 | TotalAmt |
| Program Services | $371,318 | ProgramServicesAmt |
| Management And General | $51,242 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,680 | TotalAmt |
| Program Services | $20,367 | ProgramServicesAmt |
| Management And General | $58,313 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,519 | TotalAmt |
| Management And General | $4,519 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,930,181 | TotalAmt |
| Program Services | $4,678,742 | ProgramServicesAmt |
| Management And General | $251,439 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $941,013 | TotalAmt |
| Program Services | $941,013 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $13,505,430 | $13,505,430 | |
| REPAIRS & MAINTENANCE | $2,788,235 | $1,897,696 | $890,539 |
| TAXES AND LICENSE | $178,842 | $178,842 | |
| PHYSICIAN LOAN FORGIVEN | $149,421 | $149,421 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,772 | TotalAmt |
| Program Services | $44,953 | ProgramServicesAmt |
| Management And General | $346,819 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,803,931 | TotalAmt |
| Program Services | $88,756,230 | ProgramServicesAmt |
| Management And General | $12,047,701 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,643,704 | BOYAmt |
| EOY | $23,561,668 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,750,933 | BOYAmt |
| EOY | $10,976,858 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,416 | BOYAmt |
| EOY | $374,225 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,117 | BOYAmt |
| EOY | $775,933 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $806,482 | BOYAmt |
| EOY | $876,702 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $106,126,100 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $67,049,852 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,873,515 | BOYAmt |
| EOY | $39,076,248 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,558,636 | BOYAmt |
| EOY | $42,979,927 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,806,666 | BOYAmt |
| EOY | $2,618,059 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,863,923 | BOYAmt |
| EOY | $3,397,415 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,551,392 | BOYAmt |
| EOY | $124,637,035 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,379,600 | BOYAmt |
| EOY | $13,387,245 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,877 | BOYAmt |
| EOY | $59,635 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,555,427 | BOYAmt |
| EOY | $60,818,142 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,013 | BOYAmt |
| EOY | $86,247 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,238,289 | BOYAmt |
| EOY | $20,914,403 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,437,206 | BOYAmt |
| EOY | $95,265,672 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,114,186 | BOYAmt |
| EOY | $29,371,363 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,114,186 | BOYAmt |
| EOY | $29,371,363 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,551,392 | BOYAmt |
| EOY | $124,637,035 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,308,492 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,161,554 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $110,239 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,875,781 | OtherCostOrOtherBasisAmt |
| Book Value | $1,875,781 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,313,168 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,055,094 | DepreciationAmt |
| Book Value | $22,258,074 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,050,862 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,525,259 | DepreciationAmt |
| Book Value | $525,603 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,182,329 | OtherCostOrOtherBasisAmt |
| Depreciation | $35,469,499 | DepreciationAmt |
| Book Value | $11,712,830 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,703,960 | OtherCostOrOtherBasisAmt |
| Book Value | $2,703,960 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $39,076,248 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| MINIMUM PENSION LIABILITY | $11,987,293 |
| COST REPORT SETTLEMENTS | $6,385,189 |
| ACCRUED INTEREST | $1,698,003 |
| DEFERRED PENSION EXPENSE | $708,765 |
| INTERCOMPANY LIABILITY | $135,153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $20,914,403 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE AUTHORITY IS A GOVERNMENTAL ENTITY AND IS EXEMPT FROM INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS REQUIRED TO FILE A FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY INCOME EARNED FROM NON-RELATED BUSINESS SERVICES IS SUBJECT TO TAXATION. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENTS EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2016 AND 2015 OR FOR THE YEARS THEN ENDED. THE HOSPITALS TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1384 | PersonsServedCnt |
| Total Community Benefit Expns | $1,248,736 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,248,736 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16606 | PersonsServedCnt |
| Total Community Benefit Expns | $9,753,177 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,213,704 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,539,473 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04500 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17990 | PersonsServedCnt |
| Total Community Benefit Expns | $11,001,913 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,213,704 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,788,209 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05740 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 17 | ActivitiesOrProgramsCnt |
| Persons Served | 9710 | PersonsServedCnt |
| Total Community Benefit Expns | $2,143,955 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,143,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 14000 | PersonsServedCnt |
| Total Community Benefit Expns | $3,240 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,240 | NetCommunityBenefitExpnsAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,800 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,800 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $41,224 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $41,224 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 22 | ActivitiesOrProgramsCnt |
| Persons Served | 23710 | PersonsServedCnt |
| Total Community Benefit Expns | $2,190,219 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,190,219 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02170 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 22 | ActivitiesOrProgramsCnt |
| Persons Served | 41700 | PersonsServedCnt |
| Total Community Benefit Expns | $13,192,132 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,213,704 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,978,428 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07910 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $7,016 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,016 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 62726 | PersonsServedCnt |
| Total Community Benefit Expns | $49,391 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $49,391 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 62726 | PersonsServedCnt |
| Total Community Benefit Expns | $56,407 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $56,407 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $28,703,131 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $43,810,822 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $36,577,752 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $7,233,070 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERITAGE DIAGNOSTICS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | IMAGING SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.20000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.80000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULLMAN REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1Txt |
| City | CULLMAN | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 350580609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | CRMCHOSPITAL.COM | WebsiteAddressTxt |
| State License | H2201 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | HOSPICE, CLINICS & HOME HEALTH | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULLMAN REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | CRMCHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPWWWCRMCHOSPITALCOM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPWWWCRMCHOSPITALCOM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 5 | CULLMAN REGIONAL MEDICAL CENTER, INC. (CRMC) CONTRACTED WITH ALEXANDER CONSULTING GROUP, INC. (ACG) TO ASSIST IN CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS REQUIRED BY INTERNAL REVENUE CODE. DURING THE CHNA PROCESS, CRMC SOLICITED AND TOOK INTO ACCOUNT INPUT RECEIVED FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF CULLMAN COUNTY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH THROUGH MULTIPLE METHODS. INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED WITH A BROAD RANGE OF COMMUNITY REPRESENTATIVES WHO REPRESENT THE BROAD INTERESTS OF CULLMAN COUNTY. MANY OF THE INTERVIEW AND FOCUS GROUP PARTICIPANTS HAVE SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH, AND REPRESENTED THE INTERESTS OF THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS OF CULLMAN COUNTY. IN TOTAL, 39 COMMUNITY REPRESENTATIVES PARTICIPATED IN EITHER INTERVIEWS OR FOCUS GROUPS, INCLUDING A REPRESENTATIVE FROM THE CULLMAN COUNTY HEALTH DEPARTMENT. THE PURPOSE OF THE INTERVIEWS AND FOCUS GROUPS WAS TO GAIN DIRECT INPUT FROM THESE INDIVIDUALS REGARDING IDENTIFYING AND PRIORITIZING HEALTH NEEDS, INCLUDING THE HEALTH ISSUES ASSOCIATED WITH THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AS WELL AS IDENTIFYING RESOURCES POTENTIALLY AVAILABLE TO ADDRESS THOSE HEALTH NEEDS. IN ADDITION TO CONDUCTING INTERVIEWS AND FOCUS GROUPS, COMMUNITY INPUT WAS GARNERED FROM PARTICIPANTS IN A COMMUNITY ADVISORY COMMITTEE (CAC), AS WELL AS CRMCS CHNA ADVISORY COMMITTEE. THE CAC WAS COMPRISED OF A BROAD RANGE OF COMMUNITY REPRESENTATIVES, INCLUDING THE CULLMAN COUNTY HEALTH DEPARTMENT, CULLMAN COUNTY DEPARTMENT OF HUMAN RESOURCES, GOOD SAMARITAN HEALTH CLINIC, CHURCH CLERGY, BANKERS, EDUCATORS, HEALTHCARE PERSONNEL, CULLMAN COUNTY CAREER CENTER, QUALITY OF LIFE HEALTH SERVICES, CULLMAN ECONOMIC DEVELOPMENT AGENCY, CULLMAN COUNTY COOPEATIVE EXTENSION AGENCY, USA HEALTHCARE, JUDICIAL CIRCUIT JUDGE, THE LINK OF CULLMAN COUNTY, CULLMAN COUNTY CHAMBER OF COMMERCE, AND VARIOUS CULLMAN COUNTY AND CITY GOVERNMENT OFFICIALS. THE CHNA ADVISORY COMMITTEE WAS RESPONSIBLE FOR OVERSEEING THE CHNA PROCESS, INCLUDING IDENTIFYING AND PRIORITIZING THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY. SECONDARY DATA WAS COLLECTED FROM A VARIETY OF RESPECTED ORGANIZATIONS ON A BROAD ARRAY OF HEALTH INDICATORS AND OTHER INFORMATION, AND ANALYZED AND SUMMARIZED. THE TYPES OF DATA COLLECTED INCLUDED DEMOGRAPHIC, SOCIOECONOMIC, MORTALITY AND MORBIDITY, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS, MATERNAL AND CHILD HEALTH, INSURANCE STATUS, AND GENERAL COMMUNITY/ENVIRONMENTAL INFORMATION. |
| FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 11 | AS A RESULT OF THE 2016 CHNA, THE FOLLOWING SIX CATEGORIES OF HEALTH NEEDS AND CONCERNS WERE IDENTIFIED AND PRIORITIZED. 1. HEART DISEASE 2. OBESITY 3. ACCESS TO CARE/CONTINUITY OF CARE 4. CANCER 5. SMOKING (AS PRIMARY CAUSE OF LUNG DISEASE AND LUNG CANCER) 6. SUBSTANCE ABUSE/MENTAL HEALTH THE FIRST FIVE HEALTH NEEDS ARE ADDRESSED IN THE 2016 CHNA IMPLEMENTATION STRATEGY, A COPY OF WHICH IS ATTACHED. THE LAST NEED IDENTIFIED IN THE 2016 CHNA, SUBSTANCE ABUSE/MENTAL HEALTH, WILL NOT BE SPECIFICALLY ADDRESSED BY CRMC. THIS ISSUE IS MORE APPROPRIATELY ADDRESSED BY THE VARIOUS HEALTH PARTNERS WITHIN THE COMMUNITY DUE TO CRMC'S LACK OF EXPERTISE AND LIMITED RESOURCES. |
| FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 16I | THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL AID POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED IN THE ER ABOUT THE AVAILABILITY OF FINANCIAL AID. A REPRESENTATIVE IS ALSO AVAILABLE TO DISCUSS ELIGIBILITY TO GOVERNMENT PROGRAMS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF CULLMAN COUNTY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1Txt |
| City | CULLMAN | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 350580609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | HOSPICE | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | FEDERAL POVERTY GUIDELINES (200%) ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. DISCOUNTED CARE WILL BE BASED ON MEDICARE REIMBURSEMENT. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". THE HOSPITAL UTILIZES EPSI SOFTWARE FOR COST ACCOUNTING PURPOSES. SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE AUTHORITY PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE. |
| PART III, LINE 8 - MEDICARE EXPLANATION | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL AID POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL AID, THEY ARE NOT REPORTED AS REVENUE. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | THE HOSPITAL PARTICIPATES IN THE CULLMAN COUNTY HEALTH COALITION. THIS ORGANIZATION, COMPRISED OF VARIOUS HEALTH CARE PROVIDERS AND COMMUNITY LEADERS, ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY AND STRIVES TO PROVIDE RESOURCES THAT BEST MEET THOSE NEEDS. THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT IS WIDELY PUBLICIZED ON THE HOSPITAL'S WEBSITE WWW.CRMCHOSPITAL.COM. THE IMPLEMENTATION PLAN IS ATTACHED TO THIS FORM 990. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL AID POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGHOUT THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED IN THE ER ABOUT THE AVAILABILITY OF FINANCIAL AID. A REPRESENTATIVE IS ALSO AVAILABLE TO DISCUSS ELIGIBILITY TO GOVERNMENT PROGRAMS. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | THE HOSPITAL DRAWS PATIENTS PRINCIPALLY FROM CULLMAN COUNTY AND THE NEIGHBORING COUNTIES OF WALKER, WINSTON, MARSHALL, MORGAN, AND BLOUNT. CRMC IS THE ONLY HOSPITAL IN ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA INCLUDES THE CITY OF CULLMAN, POPULATION 15,350, AND CULLMAN COUNTY, POPULATION 82,000. PER CAPITA INCOME FOR THIS AREA IS SLIGHTLY BELOW THE PER CAPITA INCOME FOR THE STATE OF ALABAMA. CULLMAN IS SERVED BY I-65, AND IS LOCATED BETWEEN HUNTSVILLE AND BIRMINGHAM. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | THE ORGANIZATION AND ITS VOLUNTEER BOARDS ARE COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS, AS WELL AS PHYSICIAN MEMBERS. THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY, 7 DAYS PER WEEK, AND IS OPEN TO ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY. HOSPITAL EMPLOYEES, IN CONJUNCTION WITH OUR LOCAL JUDGES, HAVE DEVELOPED A TRAUMA PREVENTION PROGRAM. THIS PROGRAM IS PROVIDED BY CRMC EMPLOYEES ON A VOLUNTARY BASIS. OUR LOCAL JUDGES REFER TEENAGE DRIVING OFFENDERS TO THE PROGRAM TO TEACH THEM THE IMPORTANCE OF VEHICLE SAFETY. WHILE THEY ARE HERE, THEY ACTUALLY GET TO WITNESS THE VARIOUS STAGES OF A TRAUMA ACCIDENT, FROM THE TIME THEY ARRIVE AT THE ER, UNTIL THEY LEAVE THE HOSPITAL. COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE PROVIDING AMBULANCE SUPPORT FOR VARIOUS COMMUNITY ACTIVITIES AND PROVIDING COMMUNITY SUPPORT GROUPS. THESE SUPPORT GROUPS (ALZHEIMER'S, BREAST CANCER, ETC) PROMOTE THE PHYSICAL AND MENTAL HEALTH OF THE COMMUNITY THAT WE SERVE. CRMC PROVIDES WOMEN'S FIRST AND SENIOR CHOICE PROGRAMS. THE WOMEN'S FIRST PROGRAM OFFERS SEMINARS AND EDUCATION ON HEALTH AND LIFESTYLE ISSUES SUCH AS STRESS MANAGEMENT, PMS, MENOPAUSE, AND HEART DISEASE. IT ALSO GIVES DISCOUNT ADMISSION TO WORKSHOPS AND HEALTH SCREENINGS. SENIOR CHOICE PROVIDES SERVICES TO PROMOTE EMOTIONAL, SOCIAL, AND PHYSICAL WELL BEING FOR COMMUNITY MEMBERS WHO ARE 50 AND OVER. THESE PROGRAMS CURRENTLY HAVE 6,892 MEMBERS. CRMC ALSO PROVIDES A COMMUNITY EDUCATION CENTER WHICH OFFERS MEETING ROOMS AND CATERING SERVICES FOR LOCAL BUSINESSES, CHURCHES, CIVIC ORGANIZATIONS AND EDUCATIONAL GROUPS. ALL OF OUR AMBULANCES ARE EQUIPPED WITH 12 LEAD EKG TECHNOLOGY, WHICH TRANSMITS THE INFORMATION DIRECTLY TO THE EMERGENCY ROOM PHYSICIAN, ALLOWING THEM TO GET THE INFORMATION WHILE THE PATIENT IS IN TRANSIT. THIS PROGRAM HAS REDUCED THE TIME FROM DOOR TO ANGIOPLASTY, BY GETTING THE CARDIOLOGY TEAM IN PLACE BEFORE THE PATIENT ARRIVES. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | ALABAMA |
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 | GOOD SAMARITAN CLINIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 ARNOLD ST NE | AddressLine1Txt |
| City | CULLMAN | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35055 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 200149215 | RecipientEIN |
| IRC Section | 3 | IRCSectionDesc |
| Cash Grant | $76,800 | CashGrantAmt |
| Purpose Of Grant | CURRENT OPERATIONS | 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, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL CONTINUOUSLY EVALUATES COMMUNITY ORGANIZATIONS (AS IDENTIFIED IN PART II ABOVE) PROVIDING HEALTHCARE NEEDS TO THE MEDICALLY UNDERSERVED WHO ALSO ARE MOST LIKELY UNABLE TO PAY. THE HOSPITAL EVALUATES THE NEEDS ON AN INDIVIDUAL BASIS BASED ON DOCUMENTED REQEUSTS FOR SERVICES PROVIDED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt |
|---|---|---|---|---|---|---|
| JAMES CLEMENTS | ||||||
| CEO | $210,220 | $15,862 | $61,928 | $10,273 | $298,283 | |
| CHERYL BAILEY | ||||||
| CNO | $145,575 | $8,524 | $172 | $284 | $160,456 | $5,901 |
| EDWARD MAHAN MD | ||||||
| CARDIOLOGIST | $423,873 | $154 | $10,264 | $450,376 | $16,085 | |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 1A | THE ORGANIZATION PROVIDES A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR THE CEO. ANY AMOUNTS NOT DOCUMENTED AS BUSINESS RELATED ARE INCLUDED IN THE RECIPIENT'S TAXABLE INCOME AND REPORTED ON THE FORM W-2. |
| SCHEDULE J, PART III | CEO CONTRACT JAMES CLEMENTS WAS A CONTRACTED EMPLOYEE OF BE SMITH INTERIM SERVICES SERVING AS CRMC'S CEO UNTIL HE WAS HIRED BY CRMC IN MAY 2015. CRMC PAID BE SMITH APPROXIMATELY 10,000 WEEKLY DURING THE CALENDAR YEAR 2015, OR APPROXIMATELY 160,000, FOR THE SERVICES PROVIDED BY THE CEO WHOSE DUTIES INCLUDE OPERATIONAL RESPONSIBILITY OVER THE HOSPITAL AND FOUNDATION. BONUS/INCENTIVES CERTAIN EXECUTIVE OFFICERS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE PAYMENTS ARE RELIANT ON VARIOUS ORGANIZATIONAL AND PERSONAL GOALS ESTABLISHED BY THE GOVERNING BODY. WHETHER A BONUS/INCENTIVE PAYMENT IS AWARDED IS DEPENDENT UPON THE NET PROFIT OF THE ORGANIZATION. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH CARE AUTHORITY OF CULLMAN CT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 631149220 | BondIssuerEIN |
| CUSIP | 230186AMO | CUSIPNum |
| Bond Issued | 2009-12-03 | BondIssuedDt |
| Issue Price | $68,624,416 | IssuePriceAmt |
| Purpose | DEFEASE 1993/2007 BONDS. | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $7,459,270 | RetiredAmt |
| Total Proceeds | $68,624,416 | TotalProceedsAmt |
| Refunding Escrow | $61,819,381 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $1,352,854 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $5,452,182 | WorkingCapitalExpendituresAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | Yes (true) | ChangeInUseBondFinancedPropInd |
| Change In Use Bond Financed Prop | 0.01100 | ChangeInUseBondFinancedPropPct |
| Remedial Action Taken | Yes (true) | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | false | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (true) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERRILL LYNCH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 26.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | false | SuperintegratedHedgeInd |
| Hedge Terminated | false | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | HEALTH CARE AUTHORITY OF CULLMAN CTY THE ONLY BONDS ISSUED BY THE AUTHORITY FOR THE BENEFIT OF CRMC ARE THE BONDS WHICH WERE ISSUED DECEMBER 3, 2009. A PORTION OF THE BONDS IS ALLOCABLE TO CAPITAL EQUIPMENT (THE "BOND- FINANCED EQUIPMENT") FINANCED BY CRMC AND THE AUTHORITY FOR USE AT A FREE- STANDING RADIATION ONCOLOGY CENTER OPERATED BY CRMC. THE BOND-FINANCED EQUIPMENT WAS SOLD ON DECEMBER 31, 2010 FOR CASH IN THE AMOUNT OF 800,000 TO A NONGOVERNMENTAL PERSON. THE SALE CONSTITUTES A DISPOSITION OF THE BOND-FINANCED EQUIPMENT FOR PURPOSES OF THE CHANGE IN USE RULES. WITHIN 2 YEARS OF THE SALE DATE, THE AUTHORITY USED THE DISPOSITION PROCEEDS FOR ALTERNATE USES COMPLYING WITH THE REQUIREMENTS OF TREAS. REG 1.141-12(E). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | COMMUNITY EDUCATION AND WELLNESS ACTIVITIES TO THE COMMUNITY AND IS A MAJOR CONTRIBUTOR TO A LOCAL INDIGENT CLINIC SERVICING CULLMAN COUNTY. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY (AUTHORITY)IS THE SOLE MEMBER OF CULLMAN REGIONAL MEDICAL CENTER INC. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE AUTHORITY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS AS WELL. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE AUTHORITY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | MANAGEMENT ASSISTS IN PREPARING SCHEDULES, REVIEWS THE ENTIRE DRAFT OF THE FORM 990 FOR CONTENT, AND RECOMMENDS CHANGES, IF ANY. PRIOR TO FILING, THE FINANCE COMMITTEE, CFO, AND ACCOUNTING DEPARTMENT REVIEW THE FORM. THE FINAL FORM, AS IT IS ULTIMATELY FILED WITH ALL SCHEDULES AND ATTACHMENTS, IS SENT TO EACH VOTING MEMBER, PRIOR TO FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY, BOARD MEMBERS, OFFICERS, AND DEPARTMENTAL DIRECTORS MUST IDENTIFY ANY CONFLICT, MANAGEMENT MONITORS AND MAY SUGGEST ANY AREAS OF CONFLICT. THE BOARD CHAIRMAN OR ADMINISTRATION REVIEWS ACTUAL AND PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT OF A CONFLICT, THE MEMBER OR OFFICER WITH THE CONFLICT WILL DISMISS THEMSELVES FROM THE DISCUSSION AND ANY VOTES ON THE ISSUE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNUALLY THE BOARD (OR A COMMITTEE CHARGED WITH THE RESPONSIBILITY AND AUTHORITY TO DO SO ON BEHALF OF THE BOARD) REVIEWS THE COMPENSATION PACKAGE AND PROPOSED CONTRACT OF THE CEO. THE REVIEW IS CONDUCTED BY INDEPENDENT BOARD MEMBERS, IS BASED UPON A COMPARATIVE ANALYSIS, AND IS DOCUMENTED IN THE RECORDS OF THE BOARD REFLECTING THE BASIS OF THE DETERMINATION BY THE THE BOARD (OR AUTHORIZED COMMITTEE). |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. |
| FORM 990, PART XI, LINE 9 | CHANGE IN VALUE OF INTEREST RATE SWAP 298,846 CHANGE IN TEMP REST NET ASSETS OF AFFILIATE -108,057 CHANGE IN UNRESTRICTED ASSETS OF AFFILIATE -80,550 TOTAL 110,239 OTHER CHANGES IN NET ASSETS ARE PRESENTED IN DETAIL ABOVE AND REPRESENT THOSE ITEMS WHICH DIRECTLY IMPACT THE NET ASSETS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CULLMAN REGIONAL MEDICAL CTR FNDN | ||||||||||
| 1912 ALABAMA HIGHWAY 157 | CULLMAN | AL | 350580609 | 630727880 | FOUNDATION | AL | 501C3 | 7 | NA | false |
| HEALTH CARE AUTHORITY OF CULLMAN CO | ||||||||||
| 1912 ALABAMA HIGHWAY 157 | CULLMAN | AL | 350580609 | 631149220 | AUTHORITY | AL | 501C1 | 6 | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | 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 | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments