THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON (EIN 63-6000090)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-16
IRS object ID
201631379349308333
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)
Return2016-05-16T15:50:24-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN636000090EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1REGIONAL MEDICAL CENTER BOARDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlREGIBusinessNameControlTxt
Phone2562355255PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2208AddressLine1Txt
CityANNISTONCityNm
State AbbreviationALStateAbbreviationCd
ZIP36202ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLOUIS A BASSPersonNm
Person TitleCEOPersonTitleTxt
Phone2562355255PhoneNum
Signature2016-05-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLOUIS A BASSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2208AddressLine1Txt
CityANNISTONCityNm
State AbbreviationALStateAbbreviationCd
ZIP36202ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$210,217,235GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RMCCARES.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateALLegalDomicileStateCd
Activity Or MissionTO PROVIDE PERSONALIZED HEALTHCARE TO CITIZENS OF NORTHEAST ALABAMAActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee1787TotalEmployeeCnt
Total Volunteers215TotalVolunteersCnt
Total Gross UBI$172,430TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$85,216NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$152,467PYContributionsGrantsAmt
CY Contributions Grants$220,965CYContributionsGrantsAmt
PY Program Service Revenue$183,556,366PYProgramServiceRevenueAmt
CY Program Service Revenue$204,128,393CYProgramServiceRevenueAmt
PY Investment Income$2,421,686PYInvestmentIncomeAmt
CY Investment Income$2,575,323CYInvestmentIncomeAmt
PY Other Revenue$391,049PYOtherRevenueAmt
CY Other Revenue$602,599CYOtherRevenueAmt
PY Total Revenue$186,521,568PYTotalRevenueAmt
CY Total Revenue$207,527,280CYTotalRevenueAmt
PY Grants And Similar Paid$365,589PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$381,566CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$70,052,067PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$80,874,273CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$113,900,621PYOtherExpensesAmt
CY Other Expenses$122,015,592CYOtherExpensesAmt
PY Total Expenses$184,318,277PYTotalExpensesAmt
CY Total Expenses$203,271,431CYTotalExpensesAmt
PY Revenues Less Expenses$2,203,291PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,255,849CYRevenuesLessExpensesAmt
Total Assets BOY$185,023,816TotalAssetsBOYAmt
Total Assets EOY$178,194,081TotalAssetsEOYAmt
Total Liabilities BOY$53,846,307TotalLiabilitiesBOYAmt
Total Liabilities EOY$53,575,083TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$131,177,509NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$124,618,998NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE BOARD'S MISSION IS PROVIDING STATE OF THE ART HEALTH CARE WITH INTEGRITY, TO THE PEOPLE WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$187,875,945ExpenseAmt
Grant$381,566GrantAmt
Revenue$203,955,963RevenueAmt
DescDURING THE YEAR ENDED JUNE 30, 2015, NORTHEAST ALABAMA REGIONAL MEDICAL CENTER AND JACKSONVILLE MEDICAL CENTER HAD 13,337 ADULT AND PEDIATRIC INPATIENT ADMISSIONS, 1,756 NEWBORN ADMISSIONS AND SERVED PATIENTS THROUGH AMBULATORY CARE INCLUDING: 3,712 OBSERVATION PATIENTS, 55,853 EMERGENCY DEPARTMENT PATIENTS, 64,330 REFERRED OUTPATIENTS, 6,895 SAME DAY SURGERY PATIENTS. THE MEDICAL CENTER IS ALSO INVOLVED IN EDUCATION, RESEARCH, AND COMMUNITY BENEFIT ACTIVITIES DESIGNATED TO PROVIDE HEALTH AND WELLNESS. REGIONAL MEDICAL CENTER HOLDS DESIGNATIONS FOR THE FOLLOWING: BLUE CROSS CENTER OF DISTINCTION FOR CARDIAC CARE; IS THE ONLY HOSPITAL TO RECEIVE THE "BABY FRIENDLY" DESIGNATION FROM THE STATE OF ALABAMA; ASCR GOLD STANDARD AWARD (ALABAMA STATEWIDE CANCER REGISTRY).REGIONAL MEDICAL CENTER IS PROUD TO BE CATEGORIZED AS A TIER 1 HOSPITAL BY BLUE CROSS AND BLUE SHIELD OF ALABAMA. HOSPITALS DESIGNATED AS TIER 1 ARE RECOGNIZED AS HAVING ATTAINED THE HIGHEST LEVEL OF COMPLIANCE ACROSS THE FOLLOWING AREAS: QUALITY AWARENESS, PATIENT SAFETY AWARENESS, FINANCIAL AWARENESS, AND PATIENT SATISFACTION.Desc
Total Program Service Expenses$187,875,945TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document379IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1787EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SUSAN MARNEY DIRECTOR - ACCOUNTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2562355678PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 EAST TENTH STREETAddressLine1Txt
CityANNISTONCityNm
State AbbreviationALStateAbbreviationCd
ZIP36202ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
GREGORY J KERNION
CHAIRMAN (THROUGH MAY 15)1.00Yes (X)Yes (X)$0$0$0
BILLY DON GRIZZARD
CHAIRMAN (BEGAN JUN 15)1.00Yes (X)Yes (X)$0$0$0
JAMES E ROBERTS
VICE CHAIRMAN1.00Yes (X)Yes (X)$122$0$01.00
ARTHUR F FITE III
SECRETARY1.00Yes (X)Yes (X)$100$0$01.00
SANDRA FOX SUDDUTH
BOARD MEMBER1.00Yes (X)Yes (X)$50$0$01.00
JIMMIE THOMPSON
BOARD MEMBER1.00Yes (X)$0$0$0
FRED WILSON
BOARD MEMBER1.00Yes (X)$125$0$01.00
GEORGE CRAWFORD MD
BOARD MEMBER1.00Yes (X)$0$0$0
TRUDY D HARDEGREE
BOARD MEMBER1.00Yes (X)$0$0$01.00
W E WILLIAMS
BOARD MEMBER1.00Yes (X)$100$0$0
MICHAEL W KIMBERLY DRPH MPH HCLD
BOARD MEMBER (THROUGH MAY 15)1.00Yes (X)$75$0$0
BRIAN JOHNSON
BOARD MEMBER (BEGAN SEP 14)1.00Yes (X)$0$0$0
ELLEN BASS
BOARD MEMBER1.00Yes (X)$100$0$0
PAULA WATKINS
BOARD MEMBER (BEGAN JUN 15)1.00Yes (X)$0$0$0
BUD OWSLEY
BOARD MEMBER (BEGAN JUN 15)1.00Yes (X)$0$0$0
GORDON HARDY MD
CHIEF OF STAFF1.00Yes (X)$100$0$0
ROHIT G PATEL MD
CHIEF OF STAFF (THROUGH SEPT 14)1.00Yes (X)$18,500$0$0
BLANE BATEMAN
VICE CHIEF OF STAFF (OCT 14 - SEPT 15)1.00Yes (X)$0$0$0
LARRY DEASON
BOARD MEMBER (THROUGH SEPT 14)1.00Yes (X)$1,070$0$0
J DAVID MCCORMACK
CEO (THROUGH SEPT 14)50.00Yes (X)$325,155$0$14,2911.00
LOUIS BASS
CEO (APP.DEC 14) /CFO (THRGH DEC 14)50.00Yes (X)$201,699$0$20,0991.00
MARK NORTH
CFO (APPOINTED DEC 14)50.00Yes (X)$138,824$0$18,619
JOSEPH WEAVER
COO50.00$192,288$0$25,317Yes (X)
TERRY M PHILLIS JR MD
PHYSICIAN50.00$772,377$0$21,073Yes (X)
BARRY J BILLINGS MD
PHYSICIAN50.00$655,596$0$21,081Yes (X)
MOHAMED JASSER MD
PHYSICIAN50.00$460,542$0$23,593Yes (X)
FRANK H KIM MD
PHYSICIAN50.00$357,712$0$20,374Yes (X)
MASUMI YAMAMURO MD
PHYSICIAN50.00$464,765$0$24,781Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,589,300TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$189,228TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K41IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ANESTHESIA SOLUTIONS OF ANNISTON LLC
PO BOX 6633HIGH POINTNC27262CRNA SERVICES$2,737,150
MORRISONS HEALTH CARE DIVISION
PO BOX 102289ATLANTAGA303682289MANAGEMENT OF FOOD SERVICE$1,629,356
HEALTHCARE MANAGEMENT PARTNERS LLC
9001 W 110TH STREET SUITE 260OVERLAND PARKKS66211ADMINISTRATIVE MANAGEMENT CONSULTING$957,344
ALIGN MD
624 28TH STREET NORTHBIRMINGHAMAL35203EMERGENCY DEPT PHYSICIAN SERVICES$684,000
ASSISTMED INC
15303 VENTURA BLVD SUITE 900SHERMAN OAKSCA94103TRANSCRIPTION SERVICES$437,280
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K29CntrctRcvdGreaterThan100KCnt
Government Grants$10,563GovernmentGrantsAmt
All Other Contributions$210,402AllOtherContributionsAmt
Total Contributions$220,965TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE621400$195,373,680$195,373,680
MEDICAID DISP SHARE900099$4,662,461$4,662,461
EHR PAYMENT900099$1,737,068$1,737,068
PHARMACY REVENUE900099$1,026,785$1,026,785
OTHER PROGRAMS900099$808,503$636,073$172,430

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$519,896TotalRevenueColumnAmt
Related Or Exempt Func Income$519,896RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$204,128,393TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,407,735TotalRevenueColumnAmt
Exclusion$2,407,735ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,933,851RealAmt
Personal$9,824PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$2,432,359RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$498,508RealAmt
Personal$9,824PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$488,684TotalRevenueColumnAmt
Exclusion-$488,684ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$425,184OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$257,596OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$167,588OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$167,588TotalRevenueColumnAmt
Exclusion$167,588ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
FOOD SERVICE & VENDING722210$959,161$959,161
OTHER INCOME900099$104,093$104,093
GIFT SHOP REVENUE453220$28,029$28,029
FieldValueIRS element (for citing)
Other Revenue Total$1,091,283OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$207,527,280TotalRevenueColumnAmt
Related Or Exempt Func Income$203,955,963RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$172,430UnrelatedBusinessRevenueAmt
Exclusion$3,177,922ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$78,396TotalAmt
Program Services$78,396ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$303,170TotalAmt
Program Services$303,170ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$765,211TotalAmt
Program Services$255,070ProgramServicesAmt
Management And General$510,141ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$136,340TotalAmt
Program Services$136,340ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$70,159,157TotalAmt
Program Services$64,186,425ProgramServicesAmt
Management And General$5,972,732ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,445,582TotalAmt
Program Services$4,034,846ProgramServicesAmt
Management And General$410,736ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,367,983TotalAmt
Program Services$4,872,025ProgramServicesAmt
Management And General$495,958ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$733,218TotalAmt
Management And General$733,218ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$20,650TotalAmt
Management And General$20,650ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$19,485,209TotalAmt
Program Services$16,291,413ProgramServicesAmt
Management And General$3,193,796ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,666TotalAmt
Program Services$23,666ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,656,765TotalAmt
Program Services$1,857,281ProgramServicesAmt
Management And General$799,484ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,089,382TotalAmt
Program Services$1,496,233ProgramServicesAmt
Management And General$1,593,149ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,240,690TotalAmt
Program Services$4,240,125ProgramServicesAmt
Management And General$565ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$56,682TotalAmt
Program Services$41,973ProgramServicesAmt
Management And General$14,709ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$175,940TotalAmt
Program Services$136,558ProgramServicesAmt
Management And General$39,382ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,340,517TotalAmt
Program Services$1,340,517ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$12,448,324TotalAmt
Program Services$12,448,324ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,191,052TotalAmt
Program Services$1,183,612ProgramServicesAmt
Management And General$7,440ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
UNRELATED BUSINESS INCO$13,000$13,000
MEDICAL SUPPLIES$43,783,211$43,783,211
BAD DEBT$29,556,580$29,556,580
FOOD SERVICE EXPENSES$1,474,795$1,474,795

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,725,911TotalAmt
Program Services$135,385ProgramServicesAmt
Management And General$1,590,526ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$203,271,431TotalAmt
Program Services$187,875,945ProgramServicesAmt
Management And General$15,395,486ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$347,393BOYAmt
EOY$921,383EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,500,007BOYAmt
EOY$7,459,294EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$17,669,495BOYAmt
EOY$19,441,165EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$3,145,990BOYAmt
EOY$1,975,251EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,000,976BOYAmt
EOY$5,702,127EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,101,919BOYAmt
EOY$2,296,408EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$283,208,010LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$217,337,608LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$63,660,427BOYAmt
EOY$65,870,402EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$55,864,362BOYAmt
EOY$56,730,185EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$9,006,269BOYAmt
EOY$9,006,269EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$164,000BOYAmt
EOY$164,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$22,562,978BOYAmt
EOY$8,627,597EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$185,023,816BOYAmt
EOY$178,194,081EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$14,737,905BOYAmt
EOY$14,695,273EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$704,651BOYAmt
EOY$963,721EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$37,839,716BOYAmt
EOY$36,754,545EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$564,035BOYAmt
EOY$1,161,544EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$53,846,307BOYAmt
EOY$53,575,083EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$131,167,469BOYAmt
EOY$124,608,958EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,040BOYAmt
EOY$10,040EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$131,177,509BOYAmt
EOY$124,618,998EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$185,023,816BOYAmt
EOY$178,194,081EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,255,849ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$762,421NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$10,051,939OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$25,999OtherActivitiesAmt
Total Lobbying Expenditures$25,999TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE ALABAMA HOSPITAL ASSOCIATION (ALAHA) IS ALLOCATED TO LOBBYING ACTIVITIES PERFORMED FOR THE BENEFIT OF THOSE ORGANIZATIONS' MEMBER BODIES. IN 2014, 22.80% OF DUES TO THE AHA ($7,124) AND 20.93% OF DUES PAID TO THE ALAHA ($18,875) WERE ALLOCATED TO LOBBYING EFFORTS.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,040BeginningYearBalanceAmt
End Year Balance$10,040EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,065BeginningYearBalanceAmt
Investment Earnings Or Losses-$25InvestmentEarningsOrLossesAmt
End Year Balance$10,040EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,100BeginningYearBalanceAmt
Investment Earnings Or Losses-$35InvestmentEarningsOrLossesAmt
End Year Balance$10,065EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,160BeginningYearBalanceAmt
Investment Earnings Or Losses-$60InvestmentEarningsOrLossesAmt
End Year Balance$10,100EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,200BeginningYearBalanceAmt
Investment Earnings Or Losses-$40InvestmentEarningsOrLossesAmt
End Year Balance$10,160EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,678,957OtherCostOrOtherBasisAmt
Book Value$4,678,957BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$91,314,656OtherCostOrOtherBasisAmt
Depreciation$65,651,920DepreciationAmt
Book Value$25,662,736BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,472,409OtherCostOrOtherBasisAmt
Depreciation$3,343,317DepreciationAmt
Book Value$1,129,092BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$182,175,787OtherCostOrOtherBasisAmt
Depreciation$148,342,371DepreciationAmt
Book Value$33,833,416BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$566,201OtherCostOrOtherBasisAmt
Book Value$566,201BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$65,870,402TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN QHG OF JACKSONVILLEDesc
Book Value$9,006,269BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$9,006,269TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
PROFESSIONAL LIABILITY SELF INSURANCE$495,938
WORKER'S COMPENSATION LIABILITY$104,000
PENSION DEFERRALS$561,606
FieldValueIRS element (for citing)
Total Liability$1,161,544TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$178,226,196TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$762,421NetUnrealizedGainsInvstAmt
Other Revenue$2,432,359OtherRevenueAmt
Revenue Not Reported$1,669,938RevenueNotReportedAmt
Revenue Subtotal$176,556,258RevenueSubtotalAmt
Other Revenues Not Included$30,971,022OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$30,971,022RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$207,527,280TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$174,732,768TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$2,432,359OtherExpensesIncludedAmt
Expenses Not Reported$2,432,359ExpensesNotReportedAmt
Expenses Subtotal$172,300,409ExpensesSubtotalAmt
Other Expenses Not Included$30,971,022OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$30,971,022ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$203,271,431TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE KNOX ENDOWMENT WAS ESTABLISHED IN THE 1940'S BY THE KNOX FAMILY TO PROVIDE MATERNITY CARE FOR INDIGENT HOSPITAL PATIENTS. INVESTMENT EARNINGS ON THE FUND ARE PUT TOWARDS INDIGENT MATERNITY PATIENTS ANNUALLY. THE HOSPITAL HAS DISCRETION TO USE THE FUNDS FOR MEDICAL EXPENSES BESIDES MATERNITY CARE IF NECESSARY.
PART X, LINE 2:THE BOARD IS A POLITICAL SUBDIVISION AND THE AFFILIATE IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN 501(C)(3) OF THE INTERNAL REVENUE CODE; THEREFORE, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES FOR THESE ENTITIES. THE FILING ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2015 AND 2014. FISCAL YEARS ENDED ON OR AFTER JUNE 30, 2012 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THE RELATED TAX RETURNS WERE FILED.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE NET W/ REVENUES 2,432,359.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBTS NET W/ REVENUES 29,556,580. EXPENSES NET W/REVENUES 1,414,442.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE NET W/ REVENUES 2,432,359.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBTS NET W/ REVENUES 29,556,580. EXPENSES NET W/REVENUES 1,414,442.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,895,260TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,895,260NetCommunityBenefitExpnsAmt
Total Expense0.04340TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,611,248TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,058,683DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,552,565NetCommunityBenefitExpnsAmt
Total Expense0.00850TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,506,508TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,058,683DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,447,825NetCommunityBenefitExpnsAmt
Total Expense0.05190TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$251,566TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$251,566NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,082,007TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,870,926DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,211,081NetCommunityBenefitExpnsAmt
Total Expense0.01760TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$82,686TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$82,686NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,416,259TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,870,926DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,545,333NetCommunityBenefitExpnsAmt
Total Expense0.01950TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$38,922,767TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,929,609DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,993,158NetCommunityBenefitExpnsAmt
Total Expense0.07140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$3,626,461BadDebtExpenseAmt
Reimbursed By Medicare$56,640,539ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$58,539,090CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,898,551MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsInd
NORTHEAST ALABAMA REGIONAL MEDICAL CTR
1400 EAST 10TH STREETANNISTONAL36207Yes (X)Yes (X)Yes (X)
REGIONAL MEDICAL CENTER - JACKSONVILLE
21701 PELHAM ROADJACKSONVILLEAL36265Yes (X)Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndInformation GapsInformationGapsIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndImplementation Strategy AdoptImplementationStrategyAdoptIndStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy AttachedStrategyAttachedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctIncome Level CriteriaIncomeLevelCriteriaIndAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndUnderinsurance Stat CriteriaUnderinsuranceStatCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndFAP Notice DisplayedFAPNoticeDisplayedIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndOther Method UsedOtherMethodUsedIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
NORTHEAST ALABAMA REGIONAL MEDICAL CTR
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)12Yes (1)00Yes (1)Yes (X)WWW.RMCCARES.ORGYes (X)0000Yes (1)Yes (X)200.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.RMCCARES.ORGYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (1)Yes (X)00
REGIONAL MEDICAL CENTER JACKSONVILLE
20Yes (1)00Yes (1)Yes (X)200.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.RMCCARES.ORGYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
NORTHEAST ALABAMA REGIONAL MEDICAL CTRPART V, SECTION B, LINE 5: RMC'S CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE INTERVIEW PROCESS TOOK INTO ACCOUNT INPUT FROM PERSONS, BASED ON RECOMMENDATIONS FROM THE HOSPITAL'S MANAGEMENT TEAM, WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL INCLUDING HOSPITAL MANAGEMENT, HOSPITAL BOARD, HOSPITAL MEDICAL STAFF / COMMUNITY PHYSICIANS, LOCAL AGENCIES AND PROVIDERS, AND COMMUNITY LEADERS. COLLECTIVELY, THE COMMUNITY MEMBERS SURVEYED REPRESENT HUNDREDS OF YEARS OF LIVING EXPERIENCE IN THE PRIMARY SERVICE AREA OF THE HOSPITAL AND THEREFORE PROVIDE HIGH PROBABILITY THAT RESPONDENTS KNOW AND UNDERSTAND THE COMMUNITY DYNAMICS AND ISSUES OF THE PRIMARY SERVICE AREA.
REGIONAL MEDICAL CENTER JACKSONVILLEPART V, SECTION B, LINE 2: THE ORGANIZATION PURCHASED THE HOSPITAL FACILITY OPERATED AS RMC JACKSONVILLE DURING THE YEAR.
NORTHEAST ALABAMA REGIONAL MEDICAL CTRPART V, SECTION B, LINE 11: THE ORGANIZATION PRIORITIZED THE HEALTH NEEDS ADDRESSED BASED ON FIVE CONSIDERATIONS: 1) CONSISTENCY WITH THE ORGANIZATION'S MISSION, 2) QUALITY CONSIDERATIONS, 3)GOVERNANCE AND ORGANIZATION STRUCTURE ISSUES, 4)FINANCIAL OPERATIONS IMPACTS, 5)AND RISK.
NORTHEAST ALABAMA REGIONAL MEDICAL CTRPART V, SECTION B, LINE 22D: THE ORGANIZATION CHARGES A % DISCOUNT OFF OF BILLED CHARGES BASED ON A SLIDING SCALE THAT IS TIED TO THE FEDERAL POVERTY GUIDELINES. THE ORGANIZATION PLANS TO MODIFY ITS EXISTING POLICY TO BETTER MEET THE REQUIREMENTS OF SECTION 501(R) AFTER IT HAS BEEN FINALIZED.
REGIONAL MEDICAL CENTER JACKSONVILLEPART V, SECTION B, LINE 22D: THE ORGANIZATION CHARGES A % DISCOUNT OFF OF BILLED CHARGES BASED ON A SLIDING SCALE THAT IS TIED TO THE FEDERAL POVERTY GUIDELINES. THE ORGANIZATION PLANS TO MODIFY ITS EXISTING POLICY TO BETTER MEET THE REQUIREMENTS OF SECTION 501(R) AFTER IT HAS BEEN FINALIZED.
PART V, SECTION B, LINE 16FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
NORTHEAST ALABAMA REGIONAL MEDICAL CTR PART V, SECTION B, LINE 16A WEBSITE:WWW.RMCCARES.ORG
REGIONAL MEDICAL CENTER JACKSONVILLE PART V, SECTION B, LINE 16A WEBSITE:WWW.RMCCARES.ORG
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 Line1NORTHEAST AL REGIONAL MED CENTER PSYCH UBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 EAST 10TH STREETAddressLine1Txt
CityANNISTONCityNm
State AbbreviationALStateAbbreviationCd
ZIP36202ZIPCd
FieldValueIRS element (for citing)
FacilityINPATIENT PSYCH UNITFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:OUR ORGANIZATION PROVIDES A 60% DISCOUNT TO THE BILL FOR ALL SELF PAY (UNINSURED) PATIENTS. THIS ADJUSTMENT IS APPLIED TO THE BILL PRIOR TO STATEMENTS BEING MAILED TO THE PATIENT OR GUARANTOR. WE ALSO RETAIN ON A CONTRACTED BASIS VENDORS THAT ASSIST IN SCREENING PATIENTS FOR QUALIFICATION FOR FREE OR CHARITY CARE. THIS IS ACCOMPLISHED BY MEANS OF INTERVIEWS WITH THE PATIENT AS PART OF OUR NORMAL COLLECTION PROCESS.
PART I, LN 7 COL(F):FOR PURPOSES OF CALCULATING COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSE IN LINE 7, COLUMN (F), A BAD DEBT EXPENSE OF $29,556,580 HAS BEEN ADJUSTED FROM TOTAL EXPENSES PRESENTED ON FORM 990, PART X, LINE 25.
PART III, LINE 4:BAD DEBT EXPENSE AT COST WAS CALCULATED BY MULTIPLYING TOTAL BAD DEBT EXPENSE BY THE HOSPITAL'S COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS BY DIVIDING TOTAL OPERATING COSTS INTO TOTAL CHARGES.
PART III, LINE 8:MEDICARE ALLOWABLE COSTS OF CARE WAS DERIVED FROM THE MEDICARE COST REPORT.
PART III, LINE 9B:THE CHARITY POLICY DOES NOT SPECIFICALLY ADDRESS COLLECTION PRACTICES. HOWEVER, ONCE A PERSON IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ALL COLLECTION ACTIVITY STOPS DUE TO THE FACT THAT THE ACCOUNTS ARE ADJUSTED TO A ZERO BALANCE. FOR THE INSTANCES WHERE THE PATIENT QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE, THE ACCOUNTS ARE ADJUSTED TO THE APPROPRIATE BALANCE AND THEN FOLLOW THE NORMAL COLLECTION SCHEDULES ESTABLISHED BY THE OUTSOURCED COLLECTION AGENCIES.
PART VI, LINE 2:OUR ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF OUR COMMUNITY IN SEVERAL WAYS, WHICH INCLUDES THE COMPLETION OF A COMMUNITY HEALTH NEEDS ASSESEMENT ONCE EVERY THREE YEARS (WITH THE MOST RECENT ASSESSMENT COMPLETED IN TAX YEAR 2012), AND THE COMPLETION OF AN ANNUAL UPDATE OF OUR MEDICAL STAFF DEVELOPMENT PLAN. THERE ARE SEVERAL COMPONENTS TO THIS PLAN, INCLUDING THE OVERALL POPULATION WITHIN OUR SERVICE AREA, THE AGE OF THE CURRENT MEMBERS OF OUR MEDICAL STAFF, AND PROJECTED PHYSICIAN NEEDS USING CALCULATIONS PROVIDED BY THE AMERICAN MEDICAL ASSOCIATION'S PHYSICIAN CHARACTERISTICS AND DISTRIBUTION IN THE U.S.
PART VI, LINE 3:ALL PATIENT BILLS INCLUDE A STATEMENT THAT CHARITY CARE IS AVAILABLE TO QUALIFYING INDIVIDUALS, ALONG WITH INFORMATION ON HOW TO CONTACT PERSONNEL AT THE HOSPITAL IF THE PATIENT IS INTERESTED IN DETERMINING IF THEY QUALIFY FOR FINANCIAL ASSISTANCE. SIGNS ARE ALSO POSTED IN ALL REGISTRATION AREAS, AND INFORMATION ON OUR FINANCIAL ASSISTANCE POLICY IS ALSO PROVIDED ON THE HOSPITAL'S WEBSITE.
PART VI, LINE 4:OUR SERVICE AREA IS COMPRISED OF APPROXIMATELY 200,000 PEOPLE RESIDING IN THE COUNTIES OF CALHOUN, CLEBURNE, CLAY, RANDOLPH AND TALLADEGA. ALL AGE GROUPS FROM NEWBORNS TO THE ELDERLY ARE SERVED. SERVICES INCLUDE MEDICAL/SURGICAL, INTENSIVE CARE, OBSTETRICS, PEDIATRICS, PSYCHIATRIC, CARDIOLOGY AND ONCOLOGY. ALL CITIZENS ARE SERVED REGARDLESS OF PAYER OR ABILITY TO PAY. WHILE RMC ANNISTON IS THE ONLY FULL SERVICE HOSPITAL IN THE SERVICE AREA, SMALLER HOSPITALS IN CALHOUN COUNTY INCLUDE STRINGFELLOW HOSPITAL AND RMC JACKSONVILLE. OTHER HOSPITALS IN OUR 5 COUNTY SERVICE AREA INCLUDE WEDOWEE HOSPITAL, CLAY COUNTY HOSPITAL IN CLAY COUNTY, AND CITIZENS HOSPITAL AND COOSA VALLEY MEDICAL CENTER IN TALLADEGA COUNTY. CLEBURNE AND RANDOLPH COUNTIES ARE CONSIDERED FEDERALLY DESIGNATED MEDICALLY UNDERSERVED FOR PRIMARY CARE, AND ALL COUNTIES ARE CONSIDERED UNDERSERVED FOR SPECIALTY PHYSICIANS. THE AREA ALSO QUALIFIES AS UNDERSERVED FOR PSYCHIATRIC SERVICES BY THE NATIONAL HEALTH SERVICE CORPS.
PART VI, LINE 5:REGIONAL MEDICAL CENTER PROMOTES HEALTH WITHIN THE COMMUNITY WE SERVE IN A VARIETY OF WAYS. AS A NONPROFIT, WE PROVIDE SERVICES FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, AND WE SEE A VERY HIGH NUMBER OF UNINSURED, UNDERINSURED AND INDIGENT PATIENTS IN OUR EMERGENCY DEPARTMENT. WE ASSIST THE MEMBERS OF OUR MEDICAL STAFF IN RECRUITING NEW PHYSICIANS TO THE AREA. AS PART OF OUR ASSISTANCE PROGRAM, RECRUITED PHYSICIANS MUST AGREE TO SEE ALL PATIENTS, REGARDLESS OF INCOME LEVEL OR ABILITY TO PAY. RMC PROVIDES MANY COMMUNITY SERVICES IN THE FORM OF HEALTH EDUCATION, SCREENINGS AND SUPPORT GROUPS. OUR CANCER RESOURCE CENTER, PARISH NURSING PROGRAM, AND CONGREGATIONAL HEALTH OUTREACH ARE BUT A FEW OF OUR SERVICES TO OUR COMMUNITY THAT PROVIDE HIGHLY SKILLED STAFF TO PERFORM HEALTH SCREENINGS AND EDUCATION FREE OF CHARGE.A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE MEDICAL CENTER. THE ORGANIZATION OFFERS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED LOCAL PHYSICIANS IN ALL HOSPITAL DEPARTMENTS.THE FACILITY UTILIZES SURPLUS FUNDS PRIMARILY TO PURCHASE NEW AND REPLACEMENT MEDICAL EQUIPMENT AND TO PERFORM NEEDED RENOVATIONS ON ITS PLANT. OTHER USES OF SURPLUS FUNDS MIGHT INVOLVE FUNDING EDUCATIONAL OPPORTUNITIES FOR CLINICAL STAFF AND WHEN ALLOWED, MEMBERS OF ITS MEDICAL STAFF.
PART VI, LINE 6:THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
PART VI, LINE 7, REPORTS FILED WITH STATESAL

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
EAST ALABAMA EMERGENCY MEDICAL SERVICES
PO BOX 700LINCOLNAL35096630707345501(C)(3)$15,000GENERAL ACTIVITY SPONSORSHIP
UNITED WAY OF CALHOUN COUNTY
PO BOX 1122ANNISTONAL36202630350957501(C)(3)$6,250GENERAL ACTIVITY SPONSORSHIP
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (7 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
MEDICATION/MEDICAL SUPPLIES105$26,368
TRANSPORTATION303$4,887
AMBULANCE TRANSPORTS13$7,432
FOOD4$19
SCHOLARSHIP AWARDS52$258,566
REHAB SERVICE1$5,498
SHELTER/HOUSING3$400

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HAS WRITTEN GUIDELINES FOR ORGANIZATIONS TO APPLY FOR COMMUNITY CONTRIBUTIONS (GRANTS). A DETAILED APPLICATION MUST BE COMPLETED AND APPROVED BY THE REVIEW COMMITTEE OF THE BOARD. A COPY OF THE APPLICATION IS AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINSITRATIVE OFFICE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
J DAVID MCCORMACK
CEO (THROUGH SEPT 14)$239,744$0$0$0$85,411$0$0$0$14,291$0$339,446$0$0$0
LOUIS BASS
CEO (APP.DEC 14) /CFO (THRGH DEC 14)$190,608$0$1,531$0$9,560$0$9,000$0$11,099$0$221,798$0$0$0
MARK NORTH
CFO (APPOINTED DEC 14)$129,681$0$1,058$0$8,085$0$8,080$0$10,539$0$157,443$0$0$0
JOSEPH WEAVER
COO$177,900$0$1,423$0$12,965$0$14,400$0$10,917$0$217,605$0$0$0
TERRY M PHILLIS JR MD
PHYSICIAN$545,016$0$192,377$0$34,984$0$17,492$0$3,581$0$793,450$0$0$0
BARRY J BILLINGS MD
PHYSICIAN$505,184$0$115,412$0$35,000$0$17,500$0$3,581$0$676,677$0$0$0
MOHAMED JASSER MD
PHYSICIAN$405,517$0$0$0$55,025$0$20,012$0$3,581$0$484,135$0$0$0
FRANK H KIM MD
PHYSICIAN$320,462$0$20,000$0$17,250$0$17,250$0$3,124$0$378,086$0$0$0
MASUMI YAMAMURO MD
PHYSICIAN$460,365$0$0$0$4,400$0$21,200$0$3,581$0$489,546$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AALL TRAVEL EXPENSES FOR SPOUSES AND COMPANIONS, AS WELL AS TEMPORARY HOUSING ALLOWANCES PER EMPLOYMENT AGREEMENTS, ARE ADDED AS WAGES ON THE RECIPIENTS' FORM W-2 OR 1099-MISC.
PART I, LINE 4AJ. DAVID MCCORMACK RECIEVED A SEVERANCE PAYMENT IN THE AMOUNT OF $75,000 DURING CALENDAR YEAR 2014.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RACHEL CALDWELL
FAMILY MEMBER OF CORPORATE OFFICER$51,089COMPENSATION AS EMPLOYEE OF HOSPITAL0
JOHN FITE
FAMILY MEMBER OF BOARD MEMBER$23,274COMPENSATION AS EMPLOYEE OF HOSPITAL0
MELANIE GRIZZARD
FAMILY MEMBER OF BOARD MEMBER$61,977COMPENSATION AS EMPLOYEE OF HOSPITAL0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, THE SECRETARY OF THE BOARD, THE FINANCE COMMITTEE CHAIRPERSON, THE HUMAN RESOURCES COMMITTEE CHAIRPERSON, THE PHYSICAL FACILITIES AND PROPERTIES COMMITTEE CHAIRPERSON, THE COMPLIANCE COMMITTEE CHAIRPERSON, THE CHIEF OF THE MEDICAL STAFF, AND ONE AT-LARGE BOARD MEMBER. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE ALL OF THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE CORPORATION, EXCEPT AS SUCH AUTHORITY IS LIMITED OR RESERVED BY STATUTE OR IN THE ORGANIZATION'S BYLAWS.
FORM 990, PART VI, SECTION A, LINE 4THE ORGANIZATION IS DOING BUSINESS AS RMC JACKSONVILLE
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBERS OF THE BOARD OF DIRECTORS SHALL BE THOSE DULY APPOINTED UNDER THE PROVISIONS OF ORDINANCE NO. 74-0-13 ADOPTED BY THE COUNCIL OF THE CITY OF ANNISTON, AL, ON MAY 7, 1974.
FORM 990, PART VI, SECTION A, LINE 7BTHE BOARD IS RESTRICTED FROM THE SALE OR DISPOSAL OF ANY PART OF THE REAL ESTATE USED IN CONNECTION WITH THE OPERATION OF THE MEDICAL CENTER OR THE TRANSFER OF THE OPERATION AND MANAGEMENT OF THE MEDICAL CENTER WITHOUT THE CONSENT OF THE GOVERNING BODY OF THE CITY OF ANNISTON, AL.
FORM 990, PART VI, SECTION B, LINE 11THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED INTERNALLY BY MANAGEMENT, AND FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS. AFTER THE RETURN WAS REVIEWED BY THE BOARD MEMBERS, IT WAS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS ARE REQUIRED TO DISCLOSE ON AN ANNUAL BASIS ANY POTENTIAL CONFLICTS OF INTEREST PER THE ORGANIZATION'S OFFICIAL WRITTEN POLICY. A DISINTERESTED PARTY IS ASSIGNED TO INVESTIGATE ANY CONFLICTS THAT ARISE, AND AFFECTED BOARD MEMBERS ARE ADVISED OF THE PARTY'S DECISION.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO COMPENSATION PACKAGES ARE DETERMINED BY CONDUCTING SALARY SURVEYS FROM INDIVIDUAL HOSPITALS AS WELL AS UTILIZING SALARY INFORMATION AVAILABLE FROM INDEPENDENT SOURCES SUCH AS STATE HOSPITAL ASSOCIATIONS, INDEPENDENT COMPENSATION CONSULTANTS, AND PERIODICALS. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OVERSEES THE PROCESS AND DETERMINES THE COMPENSATION FOR THE CEO AFTER REVIEW AND CONSIDERATION OF ALL RELEVANT INFORMATION. THE CEO APPROVES COMPENSATION PACKAGES FOR ALL OTHER APPLICABLE EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 18PHOTOCOPIES OF THE FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
FORM 990, PART XI, LINE 9:ADJUSTMENT TO PENSION LIABILITY -7,034,391. TRANSFER OF EQUITY -3,017,548.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MEDICAL CENTER MEMORIAL FOUNDATION INC
PO BOX 2208ANNISTONAL36202630981593EXEMPT ORG SUPPORTAL501(C)(3)LINE 7N/A0
REGIONAL HEALTH SERVICES INC
PO BOX 2208ANNISTONAL36202630721572EXEMPT ORG SUPPORTAL501(C)(3)LINE 11A, IYes (1)REGIONAL MEDICAL CENTER BOARD

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtOwnershipOwnershipPct
REGIONAL HEALTH MANAGEMENT CORPORATION
PO BOX 2345ANNISTONAL36202630819576MANAGEMENTALN/AC0
QHG OF JACKSONVILLE INC
PO BOX 2208ANNISTONAL36202621637909HEALTHCAREALCYes (1)REGIONAL MEDICAL CENTER BOARD$6,733,0641.00000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other OrgYes (1)AssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (1)AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
REGIONAL MEDICAL CENTER FOUNDATION
O$97,553
QHG OF JACKSONVILLE INC
S-$3,676,087
REGIONAL MEDICAL CENTER FOUNDATION
Q$55,896

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