RIVER REGION MEDICAL CENTER AUXILIARY: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
RIVER REGION MEDICAL CENTER AUXILIARY (EIN 58-1979882)
Tax period
2015-07-01 to 2016-06-30
Filed
2016-11-15
IRS object ID
201643209349313069
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T10:32:22-06:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN261094698PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ANTWINE ACCOUNTING SERVICEBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13527 WISCONSIN AVEAddressLine1Txt
CityVicksburgCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39180ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN581979882EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RIVER REGION MEDICAL AUXILIARYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRIVEBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 HWY 61 NORTHAddressLine1Txt
CityVICKSBURGCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39183ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAT SUMRALLPersonNm
Person TitleTREASURERPersonTitleTxt
Phone6016346465PhoneNum
Signature2016-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonREBECCA ANTWINEPreparerPersonNm
PTINP00632950PTIN
Phone6016383586PhoneNum
Preparation2016-11-15PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$90,580GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization AssocYes (X)TypeOfOrganizationAssocInd
Formation2002FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionPROVIDE SUPPORT FOR PATIENTS AND PROVIDE SCOLARSHIPS TO NURSING STUDENTSActivityOrMissionDesc
Voting Members Governing Body60VotingMembersGoverningBodyCnt
Voting Members Independent60VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers60TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$20,439PYContributionsGrantsAmt
CY Contributions Grants$20,845CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$24,524PYOtherRevenueAmt
CY Other Revenue$22,375CYOtherRevenueAmt
PY Total Revenue$44,963PYTotalRevenueAmt
CY Total Revenue$43,220CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$46,227PYOtherExpensesAmt
CY Other Expenses$44,935CYOtherExpensesAmt
PY Total Expenses$46,227PYTotalExpensesAmt
CY Total Expenses$44,935CYTotalExpensesAmt
PY Revenues Less Expenses-$1,264PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,715CYRevenuesLessExpensesAmt
Total Assets BOY$72,365TotalAssetsBOYAmt
Total Assets EOY$70,892TotalAssetsEOYAmt
Total Liabilities BOY$180TotalLiabilitiesBOYAmt
Total Liabilities EOY$422TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$72,185NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$70,470NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE SUPPORT FOR PATIENTS AND PROVIDE SCOLARSHIPS TO NURSING STUDENTSMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$24,435ExpenseAmt
DescOPERATION OF A GIFT & BEAUTY SHOP IN THE HOSPITALFOR THE MORALE & CONVIENCE OF PATIENTS, FAMILIES &VISITORS. DIFFICULT TO ESTIMATE NUMBER BENEFITTED.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$20,500ExpenseAmt
DescSCHOLARSHIPS ARE PROVIDED TO INDIVIDUALS PURSUINGNURSING DEGREESDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescMAN INFO DESK, ANSWER PHONES, SERVE COFFEE INSURGICAL WAITING AREA, READ TO PATIENTS, FAVORSDURING HOLIDAY. ESTIMATE 5000-6000 BENEFITTED.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$44,935TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members60GoverningBodyVotingMembersCnt
Independent Voting Member60IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressYes (true)OfficerMailingAddressInd
Local ChaptersYes (true)LocalChaptersInd
Policies Reference ChaptersYes (true)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMSStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPAT SUMRALLPersonNm
Phone6016346465PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 HWY 61 NORTHAddressLine1Txt
CityVICKSBURGCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39183ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp

FieldValueIRS element (for citing)
PersonPAT SUMRALLPersonNm
TitleTREASURERTitleTxt
Average Hours Per Week20.00AverageHoursPerWeekRt
Average Hours Per Week Rltd Org0.00AverageHoursPerWeekRltdOrgRt
OfficerYes (X)OfficerInd
Reportable Comp From Org$0ReportableCompFromOrgAmt
Reportable Comp From Rltd Org$0ReportableCompFromRltdOrgAmt
Other Compensation$0OtherCompensationAmt
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Membership Dues$142MembershipDuesAmt
All Other Contributions$20,703AllOtherContributionsAmt
Total Contributions$20,845TotalContributionsAmt
Gross Sales Of Inventory$69,735GrossSalesOfInventoryAmt
Cost Of Goods Sold$47,360CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,375TotalRevenueColumnAmt
Related Or Exempt Func Income$22,375RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,220TotalRevenueColumnAmt
Related Or Exempt Func Income$22,375RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
UNRELATED EXPENSES FROM 990T$19,377$19,377
SCHOLARSHIPS AWARDED$20,500$20,500
SUPPLIES$5,058$5,058

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$44,935TotalAmt
Program Services$44,935ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$39,662BOYAmt
EOY$30,336EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$32,703BOYAmt
EOY$40,556EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$72,365BOYAmt
EOY$70,892EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$180BOYAmt
EOY$422EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$180BOYAmt
EOY$422EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$72,185BOYAmt
EOY$70,470EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$72,185BOYAmt
EOY$70,470EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$72,365BOYAmt
EOY$70,892EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,715ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,565CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,968CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,406CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,439CurrentTaxYearMinus1YearAmt
Current Tax Year$20,845CurrentTaxYearAmt
Total$111,223TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$108,218CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$105,110CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,791CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$80,937CurrentTaxYearMinus1YearAmt
Current Tax Year$69,735CurrentTaxYearAmt
Total$441,791TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$137,783CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$121,078CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$104,197CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$99,376CurrentTaxYearMinus1YearAmt
Current Tax Year$90,580CurrentTaxYearAmt
Total$553,014TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$553,014PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3CurrentTaxYearMinus1YearAmt
Current Tax Year$3CurrentTaxYearAmt
Total$28TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3CurrentTaxYearMinus1YearAmt
Current Tax Year$3CurrentTaxYearAmt
Total$28TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$137,799CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$121,081CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$104,200CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$99,379CurrentTaxYearMinus1YearAmt
Current Tax Year$90,583CurrentTaxYearAmt
Total$553,042TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99990PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule G IRS990ScheduleG

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Members or stockholder classes and rights Part VI line 6MEMBERS VOLUNTEER THEIR TIME FOR THE BETTERMENT OF THE HOSPITAL AND THE PATIENTS
Member election for additional members Part VI line 7aMEMBERS ELECT OFFICERS EACH YEAR
Governing body decisions Part VI line 7bMEETINGS ARE HELD ON A REGULAR BASIS
Form 990 governing body review Part VI line 11THE OFFICERS REVIEW THE RETURN BEFORE IT IS FILED
Officer director etc mailing address Part VI line 9THE OFFICERS CAN BE REACHED AT THE HOSPITAL LOCATION
Governing documents etc available to public Part VI line 19UPON REQUEST

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