FURP.ORG / PUBLIC DATA EXPLORER

CULLMAN REGIONAL MEDICAL CENTER INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
CULLMAN REGIONAL MEDICAL CENTER INC (EIN 63-1058174)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-02-11
IRS object ID
201610429349301836
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-02-11T15:13:40-06:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN580914992PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 71309AddressLine1Txt
CityALBANYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31708ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN631058174EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CULLMAN REGIONAL MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCULLBusinessNameControlTxt
Phone2567372598PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11912 ALABAMA HIGHWAY 157AddressLine1Txt
CityCULLMANCityNm
State AbbreviationALStateAbbreviationCd
ZIP350580609ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNESHA DONALDSONPersonNm
Person TitleCFOPersonTitleTxt
Phone2567372598PhoneNum
Signature2016-02-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJACQUELINE G ATKINSPreparerPersonNm
PTINP00861721PTIN
Phone2298837878PhoneNum
Preparation2016-02-11PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAMES CLEMENTS CEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11912 ALABAMA HIGHWAY 157AddressLine1Txt
CityCULLMANCityNm
State AbbreviationALStateAbbreviationCd
ZIP350580609ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$102,978,241GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressCRMCHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1939FormationYr
Legal Domicile StateALLegalDomicileStateCd
Activity Or MissionCULLMAN 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 Body14VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee1075TotalEmployeeCnt
Total Volunteers60TotalVolunteersCnt
Total Gross UBI$1,477,857TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$311,076NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$970,661PYContributionsGrantsAmt
CY Contributions Grants$834,973CYContributionsGrantsAmt
PY Program Service Revenue$91,596,673PYProgramServiceRevenueAmt
CY Program Service Revenue$95,688,771CYProgramServiceRevenueAmt
PY Investment Income$2,332,099PYInvestmentIncomeAmt
CY Investment Income$1,413,843CYInvestmentIncomeAmt
PY Other Revenue$5,295,109PYOtherRevenueAmt
CY Other Revenue$5,014,551CYOtherRevenueAmt
PY Total Revenue$100,194,542PYTotalRevenueAmt
CY Total Revenue$102,952,138CYTotalRevenueAmt
PY Grants And Similar Paid$76,297PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$76,800CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$46,967,312PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$44,612,842CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$49,081,377PYOtherExpensesAmt
CY Other Expenses$51,250,610CYOtherExpensesAmt
PY Total Expenses$96,124,986PYTotalExpensesAmt
CY Total Expenses$95,940,252CYTotalExpensesAmt
PY Revenues Less Expenses$4,069,556PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$7,011,886CYRevenuesLessExpensesAmt
Total Assets BOY$104,627,424TotalAssetsBOYAmt
Total Assets EOY$112,551,392TotalAssetsEOYAmt
Total Liabilities BOY$85,951,042TotalLiabilitiesBOYAmt
Total Liabilities EOY$94,437,206TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,676,382NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$18,114,186NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCULLMAN 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$82,259,081ExpenseAmt
Grant$76,800GrantAmt
Revenue$98,362,690RevenueAmt
DescCRMC 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 25,813 INPATIENT DAYS CARE, 7.27% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; 44,655 EMERGENCY ROOM VISITS, 20.44% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; AND 93,783 OUTPATIENT VISITS, 17.24% 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$82,259,081TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
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 EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
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 EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document213IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee1075EmployeeCnt
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
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
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 AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonNESHA DONALDSONPersonNm
Phone2567372598PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11912 ALABAMA HWY 157AddressLine1Txt
CityCULLMANCityNm
State AbbreviationALStateAbbreviationCd
ZIP350580609ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CHERYL BAILEY
CNO/INTERIM40.002.00Yes (X)Yes (X)$152,357$0$6,431
DAVID MCKOY
PAST CHAIRMA2.00Yes (X)$0$0$0
TODD MCLEROY
CHAIRMAN2.002.00Yes (X)Yes (X)$0$0$0
ALAN WOOD
SECRETARY2.00Yes (X)Yes (X)$0$0$0
CLINT FREY
MEMBER2.00Yes (X)$0$0$0
DEL BROCK
MEMBER2.00Yes (X)$0$0$0
ROBIN HALL MD
MEMBER2.00Yes (X)$0$0$0
ROGER HUMPHREY
MEMBER2.00Yes (X)$0$0$0
GREG BARKSDALE
MEMBER2.00Yes (X)$0$0$0
JUDY BUTLER PATTERSON
VICE CHAIRMA2.00Yes (X)Yes (X)$0$0$0
MARK BUSSMAN
MEMBER2.00Yes (X)$0$0$0
LIONEL POWELL
TREASURER2.00Yes (X)Yes (X)$0$0$0
BETH ANDERSON
MEMBER2.00Yes (X)$0$0$0
BILL SMITH MD
MEMBER2.00Yes (X)$0$0$0
JAMES CLEMENTS
CURRENT CEO40.002.00Yes (X)Yes (X)$0$0$0
NESHA DONALDSON
CFO40.001.00Yes (X)$122,387$0$5,181
JEFF STANLEY
COO40.00Yes (X)$0$0$0
EDWARD MAHAN MD
CARDIOLOGIST40.00$407,991$0$19,723Yes (X)
JOEL JOHNS MD
HOSPITALIST40.00$152,345$0$4,901Yes (X)
JOHN MORRIS MD
HOSPITALIST40.00$138,759$0$5,176Yes (X)
SUSAN COPELAND
PAST VP-AMB.40.00$133,063$0$6,132Yes (X)
STACEY HILL
PAST PHARMAC40.00$130,576$0$8,841Yes (X)
JIM WEIDNER
FORMER CEO40.002.00$329,852$0$13,262Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,567,330TotalReportableCompFromOrgAmt
Total Other Compensation$69,647TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K13IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (true)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CULLMAN ANESTHESIOLOGY & PAIN CONSUL
PO BOX 1005CULLMANAL350561005CRNA SVCS$1,765,503
MEDASSETS
PO BOX 405652ATLANTAGA303845652BUS OFC SVCS$1,569,048
CROTHALL HEALTHCARE INC
13028 COLLECTION CENTER DRIVECHICAGOIL606930130ENVIRONMENTAL S$852,134
NEAREN CONSTRUCTION
116 2ND STREET SECULLMANAL350553506CONSTRUCTION$841,131
DIVERSIFIED CLINICAL SERVICES
PO BOX 636981CINCINNATIOH452636981WOUND CARE SVC$603,044
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K26CntrctRcvdGreaterThan100KCnt
Related Organizations$753,324RelatedOrganizationsAmt
Government Grants$75,691GovernmentGrantsAmt
All Other Contributions$5,958AllOtherContributionsAmt
Total Contributions$834,973TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUES623000$94,210,914$94,210,914
OUTREACH LAB SERVICES621500$716,316$716,316
CPAP MEDICAL EQUIPMENT621990$687,069$687,069
CONFERENCE CENTER532000$46,829$46,829
SPORTS FIRST713940$27,643$27,643
FieldValueIRS element (for citing)
Total Program Service Revenue$95,688,771TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,417,725TotalRevenueColumnAmt
Exclusion$1,417,725ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$234,635RealAmt
Personal$196,422PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$234,635RealAmt
Personal$196,422PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$431,057TotalRevenueColumnAmt
Related Or Exempt Func Income$196,422RelatedOrExemptFuncIncomeAmt
Exclusion$234,635ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$22,221OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$26,103OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$3,882OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,882TotalRevenueColumnAmt
Exclusion-$3,882ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
EMS MANAGEMENT FEES621910$2,691,601$2,691,601
CAFETERIA/CATERING722210$557,044$557,044
COMMUNITY SERVICE/EDUCATION624110$480,284$480,284

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$854,565TotalRevenueColumnAmt
Related Or Exempt Func Income$783,469RelatedOrExemptFuncIncomeAmt
Exclusion$71,096ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$4,583,494OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$102,952,138TotalRevenueColumnAmt
Related Or Exempt Func Income$98,362,690RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,477,857UnrelatedBusinessRevenueAmt
Exclusion$2,276,618ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$76,800TotalAmt
Program Services$76,800ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$286,356TotalAmt
Management And General$286,356ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$343,114TotalAmt
Management And General$343,114ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$34,607,095TotalAmt
Program Services$31,675,026ProgramServicesAmt
Management And General$2,932,069ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,312,629TotalAmt
Program Services$1,193,763ProgramServicesAmt
Management And General$118,866ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,470,274TotalAmt
Program Services$4,930,512ProgramServicesAmt
Management And General$539,762ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,593,374TotalAmt
Program Services$2,332,999ProgramServicesAmt
Management And General$260,375ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$4,871,593TotalAmt
Program Services$3,596,943ProgramServicesAmt
Management And General$1,274,650ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$748,596TotalAmt
Program Services$1,769ProgramServicesAmt
Management And General$746,827ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$118,117TotalAmt
Management And General$118,117ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$110,128TotalAmt
Management And General$110,128ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,170,779TotalAmt
Program Services$8,063,948ProgramServicesAmt
Management And General$2,106,831ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$387,279TotalAmt
Program Services$935ProgramServicesAmt
Management And General$386,344ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,346,755TotalAmt
Program Services$9,021,934ProgramServicesAmt
Management And General$1,324,821ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$34,059TotalAmt
Management And General$34,059ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,486,520TotalAmt
Program Services$6,139,491ProgramServicesAmt
Management And General$347,029ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$453,505TotalAmt
Program Services$427,292ProgramServicesAmt
Management And General$26,213ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$44,142TotalAmt
Program Services$21,796ProgramServicesAmt
Management And General$22,346ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$9,500TotalAmt
Management And General$9,500ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,888,230TotalAmt
Program Services$4,626,710ProgramServicesAmt
Management And General$261,520ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$864,788TotalAmt
Program Services$864,788ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$8,918,892$8,918,892
REPAIRS AND MAINT$2,401,925$355,518$2,046,407
DUES AND SUBSCRIPTIONS$159,734$159,734
TAXES AND LICENSE$136,430$136,430

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$99,638TotalAmt
Program Services$9,965ProgramServicesAmt
Management And General$89,673ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$95,940,252TotalAmt
Program Services$82,259,081ProgramServicesAmt
Management And General$13,681,171ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,340,308BOYAmt
EOY$14,643,704EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,741,334BOYAmt
EOY$9,750,933EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$385,856BOYAmt
EOY$380,416EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,074,826BOYAmt
EOY$867,117EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$910,117BOYAmt
EOY$806,482EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$100,505,299LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$62,631,784LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$37,845,079BOYAmt
EOY$37,873,515EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$41,913,473BOYAmt
EOY$42,558,636EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,580,926BOYAmt
EOY$2,806,666EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$835,505BOYAmt
EOY$2,863,923EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$104,627,424BOYAmt
EOY$112,551,392EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,417,640BOYAmt
EOY$13,379,600EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$33,988BOYAmt
EOY$32,877EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$65,045,756BOYAmt
EOY$62,555,427EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$385,712BOYAmt
EOY$231,013EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,067,946BOYAmt
EOY$18,238,289EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$85,951,042BOYAmt
EOY$94,437,206EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,676,382BOYAmt
EOY$18,114,186EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,676,382BOYAmt
EOY$18,114,186EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$104,627,424BOYAmt
EOY$112,551,392EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$7,011,886ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,102,357NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,471,725OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,875,781OtherCostOrOtherBasisAmt
Book Value$1,875,781BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$45,500,989OtherCostOrOtherBasisAmt
Depreciation$23,416,123DepreciationAmt
Book Value$22,084,866BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,050,862OtherCostOrOtherBasisAmt
Depreciation$6,428,611DepreciationAmt
Book Value$622,251BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,137,972OtherCostOrOtherBasisAmt
Depreciation$32,787,050DepreciationAmt
Book Value$11,350,922BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,939,695OtherCostOrOtherBasisAmt
Book Value$1,939,695BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$37,873,515TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
MINIMUM PENSION LIABILITY$12,257,611
COST REPORT SETTLEMENTS$3,098,153
ACCRUED INTEREST$1,734,658
DEFERRED PENSION EXPENSE$1,012,714
INTERCOMPANY LIABILITY$135,153
FieldValueIRS element (for citing)
Total Liability$18,238,289TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationTHE 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 TAKE 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 MANAGEMENT'S 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, 2015 AND 2014 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S 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

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1331PersonsServedCnt
Total Community Benefit Expns$1,477,245TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,477,245NetCommunityBenefitExpnsAmt
Total Expense0.01540TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served17444PersonsServedCnt
Total Community Benefit Expns$10,080,343TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,061,847DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,018,496NetCommunityBenefitExpnsAmt
Total Expense0.05230TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served18775PersonsServedCnt
Total Community Benefit Expns$11,557,588TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,061,847DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,495,741NetCommunityBenefitExpnsAmt
Total Expense0.06770TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs21ActivitiesOrProgramsCnt
Persons Served2261PersonsServedCnt
Total Community Benefit Expns$1,579,665TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,540DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,578,125NetCommunityBenefitExpnsAmt
Total Expense0.01640TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$339TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$339NetCommunityBenefitExpnsAmt

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,800TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,800NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served100PersonsServedCnt
Total Community Benefit Expns$19,680TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,680NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs26ActivitiesOrProgramsCnt
Persons Served2361PersonsServedCnt
Total Community Benefit Expns$1,601,484TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,540DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,599,944NetCommunityBenefitExpnsAmt
Total Expense0.01670TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs26ActivitiesOrProgramsCnt
Persons Served21136PersonsServedCnt
Total Community Benefit Expns$13,159,072TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,063,387DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,095,685NetCommunityBenefitExpnsAmt
Total Expense0.08440TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served20PersonsServedCnt
Total Community Benefit Expns$22TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served51762PersonsServedCnt
Total Community Benefit Expns$22,310TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,310NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,227TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,227NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served130PersonsServedCnt
Total Community Benefit Expns$11,384TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,100DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,284NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs12ActivitiesOrProgramsCnt
Persons Served51912PersonsServedCnt
Total Community Benefit Expns$34,943TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,100DirectOffsettingRevenueAmt
Net Community Benefit Expns$30,843NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$23,520,081BadDebtExpenseAmt
Reimbursed By Medicare$42,164,544ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$34,448,280CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$7,716,264MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1HERITAGE DIAGNOSTICSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesIMAGING SERVICESPrimaryActivitiesTxt
Org Profit Or Ownership0.21000OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.79000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CULLMAN REGIONAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11912 ALABAMA HIGHWAY 157AddressLine1Txt
CityCULLMANCityNm
State AbbreviationALStateAbbreviationCd
ZIP350580609ZIPCd
FieldValueIRS element (for citing)
Website AddressCRMCHOSPITAL.COMWebsiteAddressTxt
State LicenseH2201StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherHOSPICE, CLINICS & HOME HEALTHOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CULLMAN REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLCRMCHOSPITAL.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPWWWCRMCHOSPITALCOMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPWWWCRMCHOSPITALCOMFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 5THE CULLMAN COUNTY COMMUNITY HEALTH COALITION CREATED A TARGETED LIST OF AREAS OF EXPERTISE IN THE COMMUNITY THAT WOULD PROVIDE VALUABLE INPUT. EACH MEMBER OF THE COALITION WAS RESPONSIBLE FOR SUPPLYING AND COLLECTING SURVEYS TO THESE DIFFERENT AREAS IN THE COMMUNITY. THESE AREAS WOULD HELP GENERATE INPUT FROM A VARIETY OF SOURCES THAT WOULD HELP GENERATE AN OVERALL VIEW OF THE HEALTH OF THE COMMUNITY. THE GROUP ALSO CREATED BOTH A PRINTED SURVEY AND AN ONLINE ELECTRONIC SURVEY IN ORDER TO REACH MULTIPLE DEMOGRAPHICS THROUGHOUT THE COMMUNITY. AFTER BOTH THE SURVEY DATA AND SECONDARY DATA WERE COMPILED, DISCUSSION WAS CONDUCTED BY THE MEMBERS OF THE CULLMAN COUNTY COMMUNITY HEALTH COALITION IN ORDER TO COLLECT PRIMARY DATA ABOUT OUR COMMUNITY. THE COMMUNITY HEALTH COALITION MEMBERS REPRESENT BOTH THE HEALTHCARE COMMUNITY AND THE COMMUNITY AT LARGE; THEREFORE, THIS GROUP SERVED AS THE FOCUS GROUP PORTION OF THE NEEDS ASSESSMENT PROCESS. ONCE DATA COLLECTION WAS COMPLETE, A DISCUSSION MEETING WAS HELD WITH SEVERAL KEY COALITION AND COMMUNITY MEMBERS TO DISCUSS THE FINDINGS AND OBTAIN THEIR ASSISTANCE IN SETTING PRIORITIES TO RESPOND TO NEEDS IN THE COMMUNITY. FINALLY, A LEADERSHIP COMMITTEE WITHIN CULLMAN REGIONAL MEDICAL CENTER MET TO PRIORITIZE THESE NEEDS EVEN FURTHER AND DETERMINE HOW CULLMAN REGIONAL CAN BEST PARTICIPATE IN HELPING TO MEET THE NEEDS OF THE COMMUNITY.
FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 11PROGRESS TOWARDS THE 2013 CHNA IMPLEMENTATION PLAN 1) IMPROVE ACCESS TO HEALTH CARE BY: OADDRESS BARRIERS SUCH AS LACK OF HEALTH INSURANCE, LACK OF ABILITY TO PAY -CONTRACT WITH A MEDICAID ELIGIBILITY PROVIDER -APPROX 400-500 SCREENED PER MONTH -CHARITY CARE - PER POLICY -PROVIDE ENROLLMENT INFORMATION -ACA -ALL KIDS OGOOD SAMARITAN -PROVIDE NURSE PRACTITIONER FOR CLINIC - 76,400 -PROVIDE FREE SERVICES - 1,432 PATIENTS, 1,448,384 IN CHARGES ONURSE NAVIGATION -STEER PATIENTS TO AVAILABLE COMMUNITY RESOURCES OSTRENGTHEN RELATIONSHIPS WITH COMMUNITY CLINICS -PHYSICIAN LIAISON PROGRAM ESTABLISHED IN FY 2015 2) TREAT, EDUCATE AND PREVENT CHRONIC CONDITIONS SUCH AS OBESITY, HEART DISEASE, COPD, DIABETES, HYPERTENSION OCREATE EDUCATIONAL PROGRAMS FOR COMMUNITY MEMBERS -COMMUNITY EDUCATION SEMINARS -NEW PROGRAM - FREE PREVENTIVE HEALTH SCREENINGS -48 PEOPLE SCREENED IN FY 2015 3) PROMOTE WELLNESS FOR THE COMMUNITY OCRMC WELLNESS PROGRAM -TOBACCO CESSATION PROGRAM -PROVIDE FREE FITNESS FACILITIES -PROVIDE INCENTIVES THROUGH REDUCED HEALTH CARE COSTS -WEIGHT MANAGEMENT PROGRAMS OCOMMUNITY ACTIVITIES -EXERCISE OPTIONS FOR CERTAIN SEGMENTS OF THE COMMUNITY 4) STEER PATIENTS TO LOCAL RESOURCES FOR AN APPROPRIATE LEVEL OF CARE - CALLS RECEIVED BY CRMC NURSE NAVIGATION / CASE MANAGEMENT DEPARTMENT AND DIRECTED TO APPROPRIATE RESOURCE OGOOD SAMARITAN CLINIC -MAIL OR EMAIL APPLICATIONS TO POTENTIAL PATIENTS -INCLUDE CRMC BUSINESS CARD FOR ASSISTANCE TO COMPLETE APPLICATION -APPLICATIONS AVAILABLE THROUGH CRMC FINANCIAL COUNSELORS -FINANCIAL COUNSELORS ASSIST PATIENT TO COMPLETE APPLICATION OMEDICAID CLINIC 5) NURSE NAVIGATION PROVIDES SUPPORT AND DISTRIBUTION OF FOUNDATION FUNDS OF TWO SEPARATE FOUNDATIONS. NURSE NAV HELPS POTENTIAL PATIENTS COMPLETE APPLICATIONS AND OBTAINS FREE OR REDUCED COST MEDICATION AND TREATMENTS. THESE ARE CANCER-RELATED PROGRAMS, LOCAL COMMUNITY RESOURCES, LOCAL CHURCHES, AND LOCAL BUSINESSES THAT PROVIDE SUPPORT. OBOSOM BUDDIES - CANCER -15 PATIENTS ASSISTED OSCOTT LOCHRIDGE FOUNDATION - CANCER -10 PATIENTS OMEDICAL ALLIANCE OFIRST METHODIST, TEMPLE WOMEN'S GROUP, DESPERATION CHURCH, DAY STAR CHURCH, OPUBLIX - FREE MEDS OCULLMAN CARING FOR KIDS OTHE LINK OF CULLMAN COUNTY OCOMMISSION ON AGING ONORTHBROOK CARING CENTER OWAREHOUSE DISCOUNT OJET PEP OMURPHY'S USA 6) CRMC EMPLOYEE VOLUNTEERS FOR LOCAL ORGANIZATIONS: (HOSPITAL COMMUNITY SERVICE HOURS) OHOURS -COMMUNITY HEALTH EDUCATION 330 HOURS -COMMUNITY BASED CLINICAL SERVICE 1,696 HOURS -HEALTHCARE SUPPORT SERVICES 14,060 HOURS -SOCIAL & ENVIRONMENTAL IMPROVEMENT50 HOURS -OTHER HEALTH PROFESSIONAL EDUCATION5 HOURS -EMERGENCY & TRAUMA SERVICES90 HOURS -ECONOMIC DEVELOPMENT1 HOUR -COMMUNITY SUPPORT 672 HOURS -LEADERSHIP DEVELOPMENT48 HOURS -COMMUNITY HEALTH IMPROVEMENT ADVOCACY 108 HOURS OINCLUDES PARTICIPATION ON LOCAL BOARDS BY SENIOR LEADERSHIP, DEPARTMENT DIRECTORS, AND OTHER EMPLOYEES, SUCH AS GOOD SAMARITAN CLINIC AND THE LINK OF CULLMAN COUNTY. ALL OF THESE ORGANIZATIONS WERE CREATED TO IMPROVE THE QUALITY OF LIFE FOR THE CITIZENS OF CULLMAN COUNTY. OTRAUMA PREVENTION PROGRAM -EDUCATION ON THE RESPONSIBILITIES OF DRIVING SAFELY AND THE CONSEQUENCES THAT CAN OCCUR WHEN POOR JUDGMENT IS MADE WHILE DRIVING -PROVIDED BY CRMC EMPLOYEES, IN CONJUNCTION WITH THE CIRCUIT COURT -70 PARTICIPANTS DURING FY 2015
FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 13HTHE 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.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF CULLMAN COUNTYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11912 ALABAMA HIGHWAY 157AddressLine1Txt
CityCULLMANCityNm
State AbbreviationALStateAbbreviationCd
ZIP350580609ZIPCd
FieldValueIRS element (for citing)
FacilityHOSPICEFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CAREFEDERAL 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 EXPLANATIONTHE 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 METHODOLOGYAMOUNTS 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 STATEMENTSTHE HOSPITAL 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 EXPLANATIONMEDICARE 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 EXPLANATIONTHE 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 ASSESSMENTTHE 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. CRMC FILED A COMMUNITY HEALTH NEEDS ASSESSMENT AND IT IS AVAILIABLE ON THE HOSPITAL WEBSITE. THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND RELATED IMPLEMENTATION PLAN ARE WIDELY PUBLICIZED ON THE HOSPITAL'S WEBSITE WWW.CRMCHOSPITAL.COM. THE IMPLEMENTATION PLAN IS EMBEDDED IN THE CHNA ITSELF AND CAN BE FOUND ON PAGES 40-41.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE 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 INFORMATIONTHE 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 15,000, AND CULLMAN COUNTY, POPULATION 81,000. 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 HEALTHTHE 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 6,903 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 REPORTALABAMA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1GOOD SAMARITAN CLINICBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 ARNOLD ST NEAddressLine1Txt
CityCULLMANCityNm
State AbbreviationALStateAbbreviationCd
ZIP35055ZIPCd
FieldValueIRS element (for citing)
Recipient EIN200149215RecipientEIN
IRC Section3IRCSectionDesc
Cash Grant$76,800CashGrantAmt
Purpose Of GrantCURRENT OPERATIONSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE 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

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
CHERYL BAILEY
CNO/INTERIM CEO$152,219$138$6,149$282$158,788
JAMES CLEMENTS
CURRENT CEO
EDWARD MAHAN MD
CARDIOLOGIST$406,233$1,758$9,462$10,261$427,714
JOEL JOHNS MD
HOSPITALIST$152,242$103$234$4,667$157,246
JIM WEIDNER
FORMER CEO$184,385$145,467$3,266$9,996$343,114

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 1ATHE ORGANIZATION PROVIDES A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR THE CEO. ANY AMOUNTS CONSIDERED NONBUSINESS RELATED ARE INCLUDED IN THE RECIPIENT'S TAXABLE INCOME AND REPORTED ON THE FORM W-2.
SCHEDULE J, PAGE 1, PART I, LINE 4SUSAN COPELAND 17,997 0 0 STACEY HILL 30,760 0 0 JIM WEIDNER 144,740 0 0
SCHEDULE J, PART IIICEO CONTRACT JAMES CLEMENTS IS A CONTRACTED EMPLOYEE OF BE SMITH INTERIM SERVICES AND SERVES AS THE ORGANIZATION'S CEO. THE ORGANIZATION PAID BE SMITH 203,348 FOR THE SERVICES PROVIDED BY THE CEO WHOSE DUTIES INCLUDE OPERATIONAL RESPONSIBILITY OVER THE HOSPITAL AND FOUNDATION. TOTAL AMOUNTS PAID TO BE SMITH DURING THE CALENDAR YEAR 2014 OF 372,813 ALSO INCLUDE THE SERVICES OF PHARMACY AND HUMAN RESOURCES DEPARTMENT DIRECTORS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1HEALTH CARE AUTHORITY OF CULLMAN CTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN631149220BondIssuerEIN
CUSIP230186AMOCUSIPNum
Bond Issued2009-12-03BondIssuedDt
Issue Price$68,624,416IssuePriceAmt
PurposeDEFEASE 1993/2007 BONDS.PurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$6,020,831RetiredAmt
Total Proceeds$68,624,416TotalProceedsAmt
Refunding Escrow$61,819,381RefundingEscrowAmt
Issuance Costs From Proceeds$1,352,854IssuanceCostsFromProceedsAmt
Working Capital Expenditures$5,452,182WorkingCapitalExpendituresAmt
Substantial Completion2009SubstantialCompletionYr
Current RefundingYes (true)CurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropYes (true)ChangeInUseBondFinancedPropInd
Change In Use Bond Financed Prop0.01100ChangeInUseBondFinancedPropPct
Remedial Action TakenYes (true)RemedialActionTakenInd
Procs Nonqualified Bond RemdtdfalseProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecYes (true)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1MERRILL LYNCHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Term Of Hedge26.000000000000TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K - ADDITIONAL INFORMATIONFormAndLineReferenceDesc
ExplanationHEALTH 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 DISPOSITON 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 (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4ACOMMUNITY 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 6THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY IS THE SOLE MEMBER OF CULLMAN REGIONAL MEDICAL CENTER INC.
FORM 990, PAGE 6, PART VI, LINE 7ATHE HEALTH CARE AUTHORITY OF CULLMAN COUNTY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS AS WELL.
FORM 990, PAGE 6, PART VI, LINE 7BTHE HEALTH CARE AUTHORITY OF CULLMAN COUNTY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS OF THE ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 11BMANAGEMENT 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 12CANNUALLY, 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 15AANNUALLY 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 REVIEW OF COMPARABILITY DATA PROVIDED BY OUTSIDE CONSULTANTS, 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 19THE 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 IX, LINE 11GCONTRACT LABOR 700,366 24,081 0 MEDICAL PROFESSIONAL FEE 1,060,873 272,003 0 OUTSIDE SERVICE FEES 5,731,299 1,810,747 0 COLLECTION FEES 423,976 0 0 RECRUITING FEES 147,434 0 0
FORM 990, PART XI, LINE 9CHANGE IN VALUE OF INTEREST RATE SWAP 1,121,890 CHANGE IN TEMP REST NET ASSETS OF AFFILIATE 239,258 CHANGE IN UNRESTRICTED ASSETS OF AFFILIATE -13,519 GASB 68 IMPLEMENTATION IMPACT -7,819,354 NET DECREASE IN NET ASSETS -6,471,725

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CULLMAN REGIONAL MEDICAL CTR FNDN
1912 ALABAMA HIGHWAY 157CULLMANAL350580609630727880FOUNDATIONAL501C37NAfalse
HEALTH CARE AUTHORITY OF CULLMAN CO
1912 ALABAMA HIGHWAY 157CULLMANAL350580609631149220AUTHORITYAL501C16NAfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd