WINSTON COUNTY MEDICAL FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- WINSTON COUNTY MEDICAL FOUNDATION (EIN 64-6010402)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-08-04
- IRS object ID
- 201602179349300925
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-04T10:27:21-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 640394922 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WATKINS WARD AND STAFFORD PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | EUPORA | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39744 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 646010402 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON COUNTY MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WINS | BusinessNameControlTxt |
| Phone | 6627736211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL BLACK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6627736211 | PhoneNum |
| Signature | 2016-08-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS BROWDER CPA | PreparerPersonNm |
| PTIN | P00444647 | PTIN |
| Phone | 6622582331 | PhoneNum |
| Preparation | 2016-08-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAUL BLACK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,584,397 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WINSTONMEDICAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 249 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $29,596 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,081,369 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,783,579 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,147,305 | CYProgramServiceRevenueAmt |
| PY Investment Income | $116,659 | PYInvestmentIncomeAmt |
| CY Investment Income | $151,432 | CYInvestmentIncomeAmt |
| PY Other Revenue | $28,043,248 | PYOtherRevenueAmt |
| CY Other Revenue | $1,204,291 | CYOtherRevenueAmt |
| PY Total Revenue | $39,973,082 | PYTotalRevenueAmt |
| CY Total Revenue | $18,584,397 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,538,337 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,524,209 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,612,055 | PYOtherExpensesAmt |
| CY Other Expenses | $14,128,636 | CYOtherExpensesAmt |
| PY Total Expenses | $17,150,392 | PYTotalExpensesAmt |
| CY Total Expenses | $22,652,845 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $22,822,690 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,068,448 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,495,828 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,885,188 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,560,924 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,625,025 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,934,904 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $32,260,163 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREAS | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $21,440,590 | ExpenseAmt |
| Desc | WINSTON COUNTY MEDICAL FOUNDATION D/B/A WINSTON MEDICAL CENTER PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS INCLUDING PERSONS UNABLE TO PAY FOR REQUIRED SERVICES. | Desc |
| Total Program Service Expenses | $21,440,590 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | 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 | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 249 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 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 | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON COUNTY MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | DBA WINSTON MEDICAL CENTER | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6627736211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| LAURA HARRIS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JACK MILLER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TERRY WOODS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILL HILL | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| AL PORTER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL BLACK | |||||||
| CEO | 40.00 | $152,208 | $0 | $16,380 | Yes (X) | ||
| DUSTIN GENTRY | |||||||
| PHYSICIAN | 50.00 | $296,459 | $0 | $18,163 | Yes (X) | ||
| MICHAEL ARD | |||||||
| PHYSICIAN | 50.00 | $289,768 | $0 | $29,851 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $738,435 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $64,394 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | 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 |
|---|---|---|---|---|---|
| PRYOR MORROW ARCHITECTS | |||||
| PO BOX 167 | COLUMBUS | MS | 39703 | ARCHITECTS | $1,307,132 |
| MEDICOMP | |||||
| PO BOX 426 | MAGEE | MS | 39111 | THERAPY SERVICE | $895,421 |
| EMERGENCY ROOM MD | |||||
| 46 HOLTZENGER AVE APT G | STARKVILLE | MS | 39759 | ER PHYSICIANS | $781,200 |
| HOSPITAL HOUSEKEEPING SYSTEMS | |||||
| PO BOX 826 | SAN ANTONIO | TX | 78293 | HOUSEKEEPING | $563,126 |
| MORRISON MANAGEMENT SPECIALISTS | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD SERVICE | $425,558 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,081,369 | AllOtherContributionsAmt |
| Total Contributions | $1,081,369 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE | Desc |
| Total Revenue Column | $16,147,305 | TotalRevenueColumnAmt |
| Exclusion | $16,147,305 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,147,305 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $151,432 | TotalRevenueColumnAmt |
| Exclusion | $151,432 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $99,488 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $99,488 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $99,488 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $99,488 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INSURANCE PROCEEDS | Desc |
| Total Revenue Column | $1,104,803 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,104,803 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,104,803 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,584,397 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,204,291 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $16,298,737 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,040,122 | TotalAmt |
| Program Services | $6,338,366 | ProgramServicesAmt |
| Management And General | $701,756 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,129 | TotalAmt |
| Program Services | $338,425 | ProgramServicesAmt |
| Management And General | $39,704 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $610,148 | TotalAmt |
| Program Services | $546,082 | ProgramServicesAmt |
| Management And General | $64,066 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $495,810 | TotalAmt |
| Program Services | $443,750 | ProgramServicesAmt |
| Management And General | $52,060 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,288 | TotalAmt |
| Management And General | $30,288 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,978 | TotalAmt |
| Management And General | $70,978 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,546 | TotalAmt |
| Program Services | $42,546 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,060 | TotalAmt |
| Program Services | $12,060 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $441,487 | TotalAmt |
| Program Services | $441,487 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,984 | TotalAmt |
| Program Services | $18,286 | ProgramServicesAmt |
| Management And General | $30,698 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $569 | TotalAmt |
| Program Services | $569 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $705,287 | TotalAmt |
| Program Services | $705,287 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACT SERVICES | $4,724,552 | $4,616,313 | $108,239 |
| LOSS ON DISPOSAL | $2,508,027 | $2,508,027 | |
| BAD DEBTS | $1,558,129 | $1,558,129 | |
| RENTS | $1,360,901 | $1,352,072 | $8,829 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,624,828 | TotalAmt |
| Program Services | $2,519,191 | ProgramServicesAmt |
| Management And General | $105,637 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,652,845 | TotalAmt |
| Program Services | $21,440,590 | ProgramServicesAmt |
| Management And General | $1,212,255 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,830 | BOYAmt |
| EOY | $60,043 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,736,427 | BOYAmt |
| EOY | $2,301,731 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,501,528 | BOYAmt |
| EOY | $3,628,807 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,693 | BOYAmt |
| EOY | $134,759 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,083 | BOYAmt |
| EOY | $186,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,211,816 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $97,197 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,398,866 | BOYAmt |
| EOY | $1,114,619 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,886,401 | BOYAmt |
| EOY | $27,458,261 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,495,828 | BOYAmt |
| EOY | $34,885,188 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,560,924 | BOYAmt |
| EOY | $1,404,383 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,220,642 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,560,924 | BOYAmt |
| EOY | $2,625,025 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,934,904 | BOYAmt |
| EOY | $32,260,163 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,934,904 | BOYAmt |
| EOY | $32,260,163 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,495,828 | BOYAmt |
| EOY | $34,885,188 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,068,448 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $393,707 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,004,850 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,726 | DepreciationAmt |
| Book Value | $946,124 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $206,966 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,471 | DepreciationAmt |
| Book Value | $168,495 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,114,619 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (10 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| STATE LEVERAGE LOAN | $15,898,515 |
| NON CURRENT PROPERTY INS PROCEEDS | $8,084,741 |
| FEDERAL LEVERAGE LOAN | $2,574,438 |
| OTHER RECEIVABLES | $757,454 |
| EQUITY IN MHA INSURANCE | $141,832 |
| INTEREST RECEIVABLE | $1,281 |
| CIP | |
| DUE FROM MEDICAID (EHR) | |
| GOODWILL | |
| PROPERTY INSURANCE PROCEEDS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $27,458,261 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $18,584,397 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $18,584,397 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $18,584,397 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,652,845 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $22,652,845 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $22,652,845 | TotalExpensesPerForm990Amt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,365 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,783 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,064,820 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,726,554 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,132,185 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,739,337 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,132,185 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,739,337 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,558,129 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $63,808 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,967,022 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,966,350 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $672 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| 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 | WINSTON COUNTY MEDICAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUSIVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 16-208 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON COUNTY MEDICAL FOUNDATION | 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 |
| CHNA Conducted | 13 | 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 | WWW.WINSTONMEDICAL.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | false | ImplementationStrategyAdoptInd |
| 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FACILITY 1, WINSTON COUNTY MEDICAL FOUNDATION - PART V, LINE 5 | FormAndLineReferenceDesc |
| Explanation | THE FACILITY INQUIRED WITH COMMUNITY LEADERS AND HEALTHCARE OFFICIALS ABOUT THE NEEDS OF THE COMMUNITY. | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE METHODOLOGY USED IS A REVIEW OF THE AGINGS OF THE ACCOUNT BALANCES |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE FACILITY HAS IN PLACE A CHARITY CARE APPLICACTION FOR WHICH ANY PATIENT CAN APPLY, PROVIDED THEY MEET THE QUAL IFICATIONS ON THE APPLICATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| PAUL BLACK | ||||
| CEO | $152,208 | $12,131 | $4,249 | $168,588 |
| DUSTIN GENTRY | ||||
| PHYSICIAN | $296,459 | $11,892 | $6,271 | $314,622 |
| MICHAEL ARD | ||||
| PHYSICIAN | $289,768 | $23,760 | $6,091 | $319,619 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN WAS REVIEWED WITH MANAGEMENT AND THE TAX PREPARER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | DURING THE YEAR END AUDIT, RELATED PARTY TRANSACTIONS ARE REVIEWED. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF TRUSTEES REVIEWS THE JOB PERFORMANCE OF THE ADMINISTRATOR AND BASED UPON PAY OF OTHER SIMILAR ADMINISTRATORS ADJUSTS HIS PAY ACCORDINGL Y. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE APPLICABLE DEPARTMENT HEADS REVIEW EACH EMPLOYEE AND SUBMIT A RECOMMEN DED PAY ADJUSTMENT TO THE ADMINISTRATOR, THE ADMINISTRATOR THEN GOES TO TH E BOARD OF TRUSTEES WHO WILL DECIDE ON A PAY RAISE, IF ANY. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE TAX RETURN AND AUDIT ARE MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 24E | SUPPLIES 767,246 43,358 0 REPAIRS AND MAINTENANCE 440,382 0 0 MEDICIAD ASSESSMENTS 401,944 0 0 DRUGS 334,185 0 0 INSURANCE 281,500 0 0 MISCELLANEOUS 52,546 58,891 0 GOODWILL IMPAIRMENT 94,119 0 0 DUES & SUBSCRIPTIONS 79,310 3,388 0 FEES 67,959 0 0 |
| FORM 990, PART XI, LINE 9 | CAPITAL CONTRIBUTION 393,707 TOTAL 393,707 |
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