DELTA MEMORIAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
DELTA MEMORIAL HOSPITAL (EIN 71-0276839)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-02-11
IRS object ID
201520429349301462
Schema version
2013v4.0
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)
Return2015-02-11T10:59:28-08:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Welch Couch & Company PABusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1410 Barnett DrAddressLine1
CityBatesvilleCity
StateARState
ZIP Code72501ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN710276839EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone8703824303PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1811 HWY 65 SAddressLine1
CityDUMASCity
StateARState
ZIP Code71639ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY JONESPersonNm
Person TitleChairmanPersonTitleTxt
Signature2015-02-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM T COUCHPreparerPersonNm
PTINP00183609PTIN
Phone8707935231PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$11,813,078GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DELTAMEM.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1975FormationYr
Legal Domicile StateARLegalDomicileStateCd
Activity Or MissionDELTA MEMORIAL HOSPITAL IS COMMITTED TO AID HEALING AND PROMOTE WELLNESS FOR SOUTHEAST ARKANSASActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee206TotalEmployeeCnt
Total Volunteers32TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$280,210PYContributionsGrantsAmt
CY Contributions Grants$318,899CYContributionsGrantsAmt
PY Program Service Revenue$15,410,977PYProgramServiceRevenueAmt
CY Program Service Revenue$11,154,232CYProgramServiceRevenueAmt
PY Investment Income-$2,250,291PYInvestmentIncomeAmt
CY Investment Income$556CYInvestmentIncomeAmt
PY Other Revenue$1,016,185PYOtherRevenueAmt
CY Other Revenue$339,391CYOtherRevenueAmt
PY Total Revenue$14,457,081PYTotalRevenueAmt
CY Total Revenue$11,813,078CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,241,764PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,493,345CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,170,655PYOtherExpensesAmt
CY Other Expenses$5,913,226CYOtherExpensesAmt
PY Total Expenses$16,412,419PYTotalExpensesAmt
CY Total Expenses$12,406,571CYTotalExpensesAmt
PY Revenues Less Expenses-$1,955,338PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$593,493CYRevenuesLessExpensesAmt
Total Assets BOY$15,137,426TotalAssetsBOYAmt
Total Assets EOY$13,325,608TotalAssetsEOYAmt
Total Liabilities BOY$8,240,576TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,022,251TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,896,850NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,303,357NetAssetsOrFundBalancesEOYAmt
MissionDELTA MEMORIAL HOSPITAL IS COMMITTED TO AID HEALING AND PROMOTE WELLNESS FOR SOUTHEAST ARKANSASMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$8,799,075ExpenseAmt
DescDELTA MEMORIAL HOSPITAL PROVIDES MEDICAL HEALTH CARE SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY.Desc
Total Program Service Expenses$8,799,075TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building 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 StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
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 EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredfalseScheduleORequiredInd
IRP Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee206EmployeeCnt
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Excess Business HoldingsfalseExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
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 CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCRIS BOLINPersonNm
Phone8703924303PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1811 HWY 65 SAddressLine1
CityDUMASCity
StateARState
ZIP Code71639ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
FLORA SIMON
Director1.000.00Yes (X)$0$0$0
HEATH MONICRIEF
Director1.000.00Yes (X)$0$0$0
TIMOTHY JONES
Chairman1.000.00Yes (X)$0$0$0Yes (X)
GLENN CROW
Vice Chairman1.000.00Yes (X)$0$0$0Yes (X)
DR DAVID CHAMBERS
EX OFFICIO40.000.00Yes (X)$704,250$0$0
ROBIN SHEA
Director1.000.00Yes (X)$0$0$0
JOHN FREEMAN
Director0.000.00Yes (X)$0$0$0
SHIRLEY TEETER
Secretary1.000.00Yes (X)$0$0$0Yes (X)
CRIS BOLIN
CFO40.000.00$100,006$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$804,256TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
LEWIS NELSON BALLARD III
100 RAVENWOOD PLACEHOT SPRINGSAR71901CRNA$250,000
MARGARET ISHEE
5120 LODS FIELD RDGRAND BAYAL36541CRNA$250,000
FRANKLIN DAVID CHAMBERS
3 ROBINWOOD DRDUMASAR71639ER PHYSICIAN$275,039
REHAB CARE GROUP
PHYSICAL THERAPY SER$516,250
MICHAEL DARREN CALDWELL
BILLING$174,950
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$242,922GovernmentGrantsAmt
All Other Contributions$75,977AllOtherContributionsAmt
Total Contributions$318,899TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE$10,251,678$10,251,678
STATE ASSESSMENT REVENUE$902,554$902,554
FieldValueIRS element (for citing)
Total Program Service Revenue$11,154,232TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$556TotalRevenueColumnAmt
Exclusion$556ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$12,058RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$12,058RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,058TotalRevenueColumnAmt
Exclusion$12,058ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ELECTRONIC HEALTH RECORDS900099$169,816$169,816
GUEST AND EMPLOYEE MEALS900099$35,508$35,508
MISCELLANEOUS900099$113,331$113,331

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,678TotalRevenueColumnAmt
Related Or Exempt Func Income$8,678RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$327,333OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,813,078TotalRevenueColumnAmt
Related Or Exempt Func Income$11,481,565RelatedOrExemptFuncIncomeAmt
Exclusion$12,614ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$804,256TotalAmt
Management And General$804,256ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,759,212TotalAmt
Program Services$4,168,904ProgramServicesAmt
Management And General$590,308ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$13,386TotalAmt
Program Services$10,039ProgramServicesAmt
Management And General$3,347ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$525,524TotalAmt
Program Services$394,144ProgramServicesAmt
Management And General$131,380ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$390,967TotalAmt
Program Services$293,225ProgramServicesAmt
Management And General$97,742ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$61,490TotalAmt
Management And General$61,490ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$32,180TotalAmt
Management And General$32,180ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$300,636TotalAmt
Program Services$25,383ProgramServicesAmt
Management And General$275,253ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$49,902TotalAmt
Program Services$45,361ProgramServicesAmt
Management And General$4,541ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$305,070TotalAmt
Management And General$305,070ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,024,111TotalAmt
Program Services$1,024,111ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$288,505TotalAmt
Management And General$288,505ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$2,301,101$2,014,026$287,075
SUPPLIES & OTHER$982,581$620,702$361,879
REPAIRS & MAINTENANCE$341,772$127,764$214,008
TELEPHONE$83,638$8,701$74,937

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$142,240TotalAmt
Program Services$66,715ProgramServicesAmt
Management And General$75,525ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,406,571TotalAmt
Program Services$8,799,075ProgramServicesAmt
Management And General$3,607,496ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,697BOYAmt
EOY$317,300EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,934,210BOYAmt
EOY$2,738,538EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$236,039BOYAmt
EOY$234,278EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$233,080BOYAmt
EOY$218,204EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,873,716LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,223,482LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,564,346BOYAmt
EOY$9,650,234EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$167,054BOYAmt
EOY$167,054EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$15,137,426BOYAmt
EOY$13,325,608EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,641,386BOYAmt
EOY$2,136,541EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,369,580BOYAmt
EOY$4,763,058EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$84,094BOYAmt
EOY$77,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$145,516BOYAmt
EOY$45,652EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,240,576BOYAmt
EOY$7,022,251EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$185,354BOYAmt
EOY-$384,479EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,082,204BOYAmt
EOY$6,687,836EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,896,850BOYAmt
EOY$6,303,357EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,137,426BOYAmt
EOY$13,325,608EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$593,493ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$105,910OtherCostOrOtherBasisAmt
Book Value$105,910BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,356,078OtherCostOrOtherBasisAmt
Depreciation$4,680,313DepreciationAmt
Book Value$7,675,765BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,411,728OtherCostOrOtherBasisAmt
Depreciation$3,543,169DepreciationAmt
Book Value$1,868,559BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,650,234TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDELINQUENT PAYROLL TAXES PAYABLEDesc
Amt$45,652Amt
FieldValueIRS element (for citing)
Total Liability$45,652TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$12,207,446TotalRevEtcAuditedFinclStmtAmt
Other Revenue$394,368OtherRevenueAmt
Revenue Not Reported$394,368RevenueNotReportedAmt
Revenue Subtotal$11,813,078RevenueSubtotalAmt
Total Revenue Per Form990$11,813,078TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,406,571TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$12,406,571ExpensesSubtotalAmt
Total Expenses Per Form990$12,406,571TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X : FIN48 FootnoteMANAGEMENT ANNUALLY REVIEWS ITS TAX POSITION AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE FINANCIAL STATEMENTS.
Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990RELEASE OF RESTRICTIONS $394368

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,476TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$39,476NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,476TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$39,476NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,476TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$39,476NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,974,719BadDebtExpenseAmt
Bad Debt Expense Attributable$1,184,831BadDebtExpenseAttributableAmt
Reimbursed By Medicare$4,272,177ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,024,819CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$247,358MedicareSurplusOrShortfallAmt
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnfalseFinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA MEMORIAL HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1811 HWY 65SAddressLine1
CityDUMASCity
StateARState
ZIP Code71639ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

FieldValueIRS element (for citing)
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 Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Prioritize ServicesYes (X)PrioritizeServicesInd
Other Needs AddressedYes (X)OtherNeedsAddressedInd
All Needs AddressedYes (true)AllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Form4720 FiledfalseForm4720FiledInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.0000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care200.0000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Permit LawsuitYes (X)PermitLawsuitInd
Collection ActivitiesYes (true)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
LawsuitYes (X)LawsuitInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 3 - Account Input from Person Who Represent the CommunityDEVELOPED A STEERING COMMITTEE AND HELD COMMUNITY MEETINGS THAT PRESENTED SURVEYS TO COMMITTEE MEMEBERS FOR INPUT
Part V, Line 6i - Describe Other Needs IdentifiedTHE HOSPITAL SET A GOAL OF INCREASING AVAILABLE HEALTH EDUCATION PROGRAMS IN THE SERVICE AREA. THE HOSPITAL WORKED WITH OTHER GROUPS TO OFFER INSURANCE ENROLLMENT CERTIFICATION TRAINING, CPR, AND HEALTH EDUCATION CLASSES. THE HOSPITAL ALSO FORMED PARTNERSHIPS WITH LOCAL BUSINESSES TO PROVIDE WORKSITE WELLNESS PROGRAM AVAILABLE TO ALL LOCAL EMPLOYERS.

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI - Needs AssessmentUTILIZES ANNUAL STATISTICAL REPORT WITH DEMOGRAPHIC INFORMATION FORM DHS AS WELL AS REPORTS SHOWING PERCENT OF ACTIVITY OF COMMUNITY BY PAYOR SOURCE.
Part VI - Patient Education of Eligibility for AssistanceINFORMS PATIENTS UPON ADMISSION AND POSTS NOTICES IN CONSPICUOUS AREAS.
Part VI - Community InformationRURAL SETTING, PREDOMINANTLY AGRICULTURAL BASE. AVERAGE INCOME AT OR BELOW FEDERAL POVERTY GUIDELINES. PREDOMINANTLY CAUCASIAN, HIGH SCHOOL EDUCATED AND GERIATRIC IN NATURE.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposePROVIDES DUMAS SCHOOL ATHLETES PHYSICALS FREE OF CHARGE, PARTICIPATES IN NUMEROUS COMMUNITY HEALTH FAIRS AND PROVIDES HEALTH SCREENINGS, NEW MOM/BIRTHING CLASSES, CAR SEAT SAFETY TRAINING, BABYSITTING TRAINING CLASSES,AND MEALS FOR COMMUNITY EVENTS

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
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
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDR DAVID CHAMBERSPersonNm
TitleEX OFFICIOTitleTxt
Base Compensation Filing Org$704,250BaseCompensationFilingOrgAmt
Total Compensation Filing Org$704,250TotalCompensationFilingOrgAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessNo review was or will be conducted.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsANNUAL CONFLICT OF INTEREST FORM COMPLETED BY EACH BOARD MEMBER
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNo documents available to the public.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.