MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED (EIN 31-0650283)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-10
- IRS object ID
- 201523149349302512
- Schema version
- 2014v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-10T12:44:28-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8800 LYRA DRIVE SUITE 450 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310650283 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MCCU | BusinessNameControlTxt |
| Phone | 5135245310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR STREET | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45056 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRYAN HEHEMANN | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5135245310 | PhoneNum |
| Signature | 2015-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NANCY KIRCHNER | PreparerPersonNm |
| PTIN | P00386751 | PTIN |
| Phone | 6148852583 | PhoneNum |
| Preparation | 2015-11-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRYAN HEHEMANN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR STREET | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $59,059,203 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MHMH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL FACILITY DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 638 | TotalEmployeeCnt |
| Total Volunteers | 230 | TotalVolunteersCnt |
| Total Gross UBI | $101,428 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$50,321 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $319,340 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,161,989 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $60,187,052 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $56,885,046 | CYProgramServiceRevenueAmt |
| PY Investment Income | $32,371 | PYInvestmentIncomeAmt |
| CY Investment Income | -$38,462 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,075,373 | PYOtherRevenueAmt |
| CY Other Revenue | $918,584 | CYOtherRevenueAmt |
| PY Total Revenue | $62,614,136 | PYTotalRevenueAmt |
| CY Total Revenue | $58,927,157 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $17,800 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $29,350 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,295,900 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,441,661 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,089,514 | PYOtherExpensesAmt |
| CY Other Expenses | $30,501,297 | CYOtherExpensesAmt |
| PY Total Expenses | $62,403,214 | PYTotalExpensesAmt |
| CY Total Expenses | $59,972,308 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $210,922 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,045,151 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $43,437,362 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,544,327 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,401,702 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,666,789 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,035,660 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,877,538 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ACUTE CARE HOSPITAL FACILITY DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,401,519 | ExpenseAmt |
| Revenue | $25,986,706 | RevenueAmt |
| Desc | SURGERY-IS COMPRISED OF SURGERY, AND ENDO/MINOR PROCEDURES. TOTAL VOLUME IS 4,862 CONSISTING OF IP CARE (14%) AND OUTPATIENT CARE (86%). | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,058,516 | ExpenseAmt |
| Revenue | $12,129,070 | RevenueAmt |
| Desc | INPATIENT CARE INPATIENT VOLUME CONSISTED OF 2,008 DISCHARGES AND 6,587 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 3.3 DAYS. BIRTHS TOTALED 410 WITH A TOTAL OF 955 OBSERVATION DAYS OF SERVICE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,058,227 | ExpenseAmt |
| Revenue | $12,598,100 | RevenueAmt |
| Desc | PHARMACY-CONSISTING OF CARE PROVIDED TO INPATIENTS (22%) AND OUTPATIENTS (78%). OUTPATIENT CARE INCLUDES A MAJOR PROGRAM FOR ONCOLOGY TREATMENT. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $35,809,856 | ExpenseAmt |
| Grant | $29,350 | GrantAmt |
| Revenue | $87,811,774 | RevenueAmt |
| Desc | OVERALL, INPATIENT AND OUTPATIENT CARE REPRESENT 25% AND 75% OF GROSS PATIENT REVENUE, RESPECTIVELY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $35,809,856 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $29,350 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $87,811,774 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $50,328,118 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 64 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 638 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES MILLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5135245310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR STREET | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 450561292 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOHN HARLAND MD | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SUSAN CROSS LIPNICKEY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD M NORMAN | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALAN OAK | ||||||||
| SECRETARY-TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THOMAS W SPEH | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN FLEE | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RALPH R GUTOWSKI | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ERIKA DARKS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HILLARY EVANS MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES FORMAL | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRYAN HEHEMANN | ||||||||
| CEO | 40.00 | Yes (X) | $213,624 | $0 | $19,295 | 40.00 | ||
| JOHN CLEMENTS | ||||||||
| VP & CFO | 40.00 | Yes (X) | $146,434 | $0 | $8,908 | 40.00 | ||
| BRYAN MCCULLOUGH | ||||||||
| PHYSICIAN | 40.00 | $577,486 | $0 | $30,024 | Yes (X) | |||
| MARK CRISTELL | ||||||||
| PT DIRECTOR | 40.00 | $137,819 | $0 | $19,965 | Yes (X) | |||
| MATTHEW DAGGY | ||||||||
| PHYSICIAN | 40.00 | $242,064 | $0 | $22,730 | Yes (X) | |||
| PAUL CANGEMI | ||||||||
| PHYSICIAN | 40.00 | $289,191 | $0 | $7,311 | Yes (X) | |||
| GREGORY CALKINS | ||||||||
| PHYSICIAN | 40.00 | $206,675 | $0 | $22,887 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,813,293 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $131,120 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WESTERN OHIO ANESTHESIA | |||||
| PO BOX 361036 | CINCINNATI | OH | 45263 | ANESTHESIA | $395,000 |
| MAYO MEDICAL LABORATORIES | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 55480 | MEDICAL | $323,427 |
| ESCO COMMUNICATIONS INC | |||||
| PO BOX 1243 | INDIANAPOLIS | IN | 46206 | NURSE CALL SYSTEM | $287,219 |
| CHRIST HOSPITAL | |||||
| 2139 AUBURN AVE | CINCINNATI | OH | 45219 | PHYSICIAN SERVICES | $281,923 |
| COMMUNITY BLOOD | |||||
| PO BOX 644634 | PITTSBURGH | PA | 15264 | BLOOD AND BLOOD PRODUCTS | $274,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $462,295 | RelatedOrganizationsAmt |
| All Other Contributions | $699,694 | AllOtherContributionsAmt |
| Total Contributions | $1,161,989 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $56,885,046 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,885,046 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $56,885,046 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,915 | TotalRevenueColumnAmt |
| Exclusion | $11,915 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $236,452 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $236,452 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $236,452 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $101,428 | UnrelatedBusinessRevenueAmt |
| Exclusion | $135,024 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $81,669 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $132,046 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$50,377 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$50,377 | TotalRevenueColumnAmt |
| Exclusion | -$50,377 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MANAGEMENT INCOME | 900099 | $295,605 | $295,605 | |
| CAFETERIA/VENDING | 722210 | $242,924 | $242,924 | |
| WELLNESS CENTER | 900099 | $82,564 | $82,564 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,039 | TotalRevenueColumnAmt |
| Exclusion | $61,039 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $682,132 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,927,157 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,263,215 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $101,428 | UnrelatedBusinessRevenueAmt |
| Exclusion | $400,525 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,350 | TotalAmt |
| Program Services | $29,350 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $533,899 | TotalAmt |
| Program Services | $395,085 | ProgramServicesAmt |
| Management And General | $138,814 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,937,837 | TotalAmt |
| Program Services | $16,254,173 | ProgramServicesAmt |
| Management And General | $5,683,664 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,395,945 | TotalAmt |
| Management And General | $5,395,945 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,573,980 | TotalAmt |
| Management And General | $1,573,980 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,174 | TotalAmt |
| Management And General | $539,174 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,200 | TotalAmt |
| Management And General | $120,200 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,634,065 | TotalAmt |
| Program Services | $4,287,076 | ProgramServicesAmt |
| Management And General | $2,346,989 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,642 | TotalAmt |
| Program Services | $6,221 | ProgramServicesAmt |
| Management And General | $325,421 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,682,700 | TotalAmt |
| Program Services | $1,131,839 | ProgramServicesAmt |
| Management And General | $550,861 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,247,482 | TotalAmt |
| Program Services | $366,143 | ProgramServicesAmt |
| Management And General | $1,881,339 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,333 | TotalAmt |
| Program Services | $31,858 | ProgramServicesAmt |
| Management And General | $15,475 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,312 | TotalAmt |
| Program Services | $39,380 | ProgramServicesAmt |
| Management And General | $8,932 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,585 | TotalAmt |
| Management And General | $392,585 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,370,690 | TotalAmt |
| Management And General | $3,370,690 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,830 | TotalAmt |
| Program Services | $20,490 | ProgramServicesAmt |
| Management And General | $288,340 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OFFICE /MEDICAL SUPPLIE | $10,013,447 | $9,436,483 | $576,964 |
| BAD DEBT | $3,780,521 | $3,780,521 | |
| MISCELLANEOUS | $984,316 | $52,486 | $931,830 |
| INDIRECT A&G ALLOCATION | $0 | $18,277,534 | -$18,277,534 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,972,308 | TotalAmt |
| Program Services | $50,328,118 | ProgramServicesAmt |
| Management And General | $9,644,190 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,863 | BOYAmt |
| EOY | $2,700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,839,824 | BOYAmt |
| EOY | $1,629,341 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,266,724 | BOYAmt |
| EOY | $6,744,043 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $13,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,104,485 | BOYAmt |
| EOY | $1,119,975 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,399,254 | BOYAmt |
| EOY | $1,465,188 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $78,493,220 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $55,516,661 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,528,862 | BOYAmt |
| EOY | $22,976,559 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,293,350 | BOYAmt |
| EOY | $4,593,521 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,437,362 | BOYAmt |
| EOY | $38,544,327 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,547,365 | BOYAmt |
| EOY | $3,410,565 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,450,826 | BOYAmt |
| EOY | $10,648,803 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $355,807 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,403,511 | BOYAmt |
| EOY | $1,251,614 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,401,702 | BOYAmt |
| EOY | $15,666,789 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,035,660 | BOYAmt |
| EOY | $22,877,538 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,035,660 | BOYAmt |
| EOY | $22,877,538 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,437,362 | BOYAmt |
| EOY | $38,544,327 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,045,151 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $86,206 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$199,177 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $6,019 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,019 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | SUPPORT PROVIDED THRU DUES PAID TO OHA AND AHA FOR DIRECT COMMUNICATION WITH CERTAIN MEMBERS OF FEDERAL, STATE, OR LOCAL GOVERNMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $548,616 | OtherCostOrOtherBasisAmt |
| Book Value | $548,616 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,912,436 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,647,590 | DepreciationAmt |
| Book Value | $12,264,846 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,321,731 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,829,422 | DepreciationAmt |
| Book Value | $2,492,309 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,312,336 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,039,649 | DepreciationAmt |
| Book Value | $7,272,687 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $398,101 | OtherCostOrOtherBasisAmt |
| Book Value | $398,101 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,976,559 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| UNAMORTIZED FINANCE COSTS | $103,036 |
| DOCTORS' LOANS RECEIVABLE | $422,537 |
| CASH SURRENDER VALUE | $54,377 |
| DUE FROM RELATED PARTY | $124,461 |
| BOARD DESIGNATED INVESTMENTS | $3,579,321 |
| BWC REBATE | $309,789 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,593,521 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | $124,429 |
| OTHER LIABILITIES | $1,127,185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,251,614 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $59,013,363 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $86,206 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $86,206 | RevenueNotReportedAmt |
| Revenue Subtotal | $58,927,157 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $58,927,157 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $60,171,485 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $199,177 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $199,177 | ExpensesNotReportedAmt |
| Expenses Subtotal | $59,972,308 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $59,972,308 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2014 AND 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE RECLASS 199,177. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $836,185 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $913,325 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$77,140 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,422,148 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,653,030 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,769,118 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04620 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,258,333 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,566,355 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,691,978 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $146,392 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $146,392 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,600 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $147,992 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $147,992 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,406,325 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,566,355 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,839,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04860 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,780,521 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $65,916 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,327,271 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,672,710 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,345,439 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH HYDE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N POPLAR ST | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://MHMH.ORG/ABOUT-ANNUAL.ASPX | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://MHMH.ORG/ABOUT-ANNUAL.ASPX | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: REGIONAL HEALTH NEEDS ASSESSEMENT CONDUCTED BY GREATER CINCINNATI HEALTH COUNCIL |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7D: COMMUNITY FORUMS |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 22D: APPLIED 30% DISCOUNT |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | HTTP://WWW.MHMH.ORG/PATIENTS-REFUND.ASPX |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | HTTP://WWW.MHMH.ORG/PATIENTS-REFUND.ASPX |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ||||
| 5151 MORNING SUN ROAD | OXFORD | OH | 45056 | PHYSICAL THERAPY |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ||||
| 10058 COOLEY RD | BROOKVILLE | IN | 47012 | OUTPATIENT |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ||||
| 1390 EATON RD | HAMILTON | OH | 45013 | PHYSICAL THERAPY |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ||||
| 2449 ROSS-MILLVILLE RD | HAMILTON | OH | 45013 | OUTPATIENT, URGENT CARE, PT |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ||||
| 79 W CENTRAL AVENUE | CAMDEN | OH | 45311 | OUTPATIENT |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ||||
| 961 MAIN STREET | HAMILTON | OH | 45013 | ORTHO PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, COMMUNITY BUILDING ACTIVITIES: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL PROMOTES HEALTH AND WELLBEING IN OUR COMMUNITY IN NUMEROUS WAYS NOT LISTED IN THE COMMUNITY EVENTS AND PROGRAMS SECTION OF THE 990. EXAMPLES INCLUDE: 1. MHMH HELPED PROMOTE WELLNESS BY PROVIDING MEETING SPACE TO THE INFANT/CHILD LOSS BEREAVEMENT SUPPORT GROUP AND FIBROMYALGIA SUPPORT GROUP. 2. MHMH ASSISTED OUR LOCAL SCHOOL DISTRICT WITH IDENTIFIEDHEALTH/WELLNESS NEEDS. EXAMPLES INCLUDE: A. DEVELOPED AND PROVIDED CRISIS CARDS FOR ALL 8TH GRADERS AND ALL COUNSELORS IN THE SCHOOL DISTRICT B. DEVELOPED CURRICULUM THAT COMBINED TRADITIONAL LEARNING WITH EXERCISE TO HELP FIGHT OBESITY IN OUR ELEMENTARY STUDENTS C. DEVELOPED AND HELD MINI HEALTH SEMINARS FOR 6TH GRADE STUDENTS ON SLEEP, NUTRITION, EXERCISE AND MENTAL HEALTH 3. MHMH PROVIDED OFFICE SPACE AND MEETING SPACE FOR THE OXFORD COLLEGE CORNER CLINIC, WHICH IS A CLINIC THAT PROVIDES FREE HEALTH CARE TO THE UNINSURED AND UNDERINSURED ADULTS IN OUR COMMUNITY 4. MHMH IMPROVED ITS EMPLOYEE WELLNESS PROGRAM BY: A. IMPLEMENTING A HEALTH RISK ASSESSMENT FOR ITS EMPLOYEES TO IDENTIFY HEALTH NEEDS/CONCERNS IN OUR EMPLOYEE POPULATION B. OFFERING MAMMOGRAMS AND PROSTATE SCREENING TO APPROPRIATE EMPLOYEES FREE OF CHARGE C. INCENTIVIZING EMPLOYEES TO ADOPT HEALTHIER BEHAVIOR |
| PART III, LINE 2: | A COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 OF THE 2014 IRSINSTRUCTIONS FOR SCHEDULE H AS A COSTING METHODOLOGY USED TO CALCULATE THEAMOUNTS REPORTED IN PART III, LINE 2 AND LINE 3 FOR THE ORGANIZATION'S BADDEBT EXPENSE AT COST. |
| PART III, LINE 3: | THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WILL LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE HOSPITAL'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THE SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE DECEMBER 31, 2014 AND 2013 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF $6,534,397 AND $8,059,531, RESPECTIVELY, RELATES TO RESERVES FOR SELF-PAY BALANCES.THE ALLOWANCE FOR DOUBTFUL ACCOUNTS REPRESENTS A PERCENT OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2014 AND 2013, RESPECTIVELY. THE HOSPITAL'S SELF-PAY PROVISION FOR BAD DEBTS DECREASED $3,103,530 FROM $6,884,053 IN 2013 TO $3,780,523 IN 2014. THE DECREASE IN THE PROVISION FOR BAD DEBTS WAS A RESULT OF DECREASED SELF-PAY REVENUE. ALLOWANCE FOR DOUBTFUL ACCOUNTS AT DECEMBER 31, 2014 DECREASED DUE TO THE DECREASED BALANCE OF SELF-PAY ACCOUNTS AT YEAR END.THE HOSPITAL DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS RELATING TO DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED DECEMBER 31, 2014 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. |
| PART III, LINE 9B: | ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE/FINANCIAL ASSISTANCE, COLLECTION PRACTICES ARE STOPPED. |
| PART VI, LINE 2: | MCCULLOUGH-HYDE PARTICIPATED IN A PROCESS OF COMMUNITY NEEDS ASSESSMENT DURING 2013. THE PROCESS INCLUDED THE FOLLOWING ELEMENTS:1. A NEEDS ASSESSMENT THAT SERVES AS A FOUNDATION FOR DEVELOPING AN IMPLEMENTATION STRATEGY TO ADDRESS THOSE NEEDS. THE QUESTION OF HOW THE HOSPITAL CAN BEST USE ITS LIMITED RESOURCES TO ASSIST COMMUNITIES IN NEED WILL BE ADDRESSED IN THE IMPLEMENTATION PHASE.2. THE NEEDS ASSESSMENT SEEKS TO IDENTIFY PRIORITY HEALTH STATUS AND ACCESS ISSUES FOR OUR SERVICE AREA. MCCULLOUGH-HYDE MEMORIAL HOSPITAL IS COMMITTED TO TAKING A LEADERSHIP ROLE IN THE ASSESSMENT AND IMPLEMENTATION PHASES. THE ASSESSMENT FOCUSED ON THE FOLLOWING QUESTIONS: -WHO IN THE COMMUNITY IS MOST VULNERABLE IN TERMS OF HEALTH STATUS OR ACCESS TO CARE? -WHAT ARE THE UNIQUE HEALTH STATUS AND/OR ACCESS NEEDS FOR OUR POPULATION? -WHERE DO THESE PEOPLE LIVE IN OUR COMMUNITY? -WHY ARE THESE PROBLEMS PRESENT?3. MCCULLOUGH-HYDE MEMORIAL HAS IDENTIFIED ITS COMMUNITY AS THE RESIDENTS OF FIVE (5) COUNTIES. IN OHIO: BUTLER AND PREBLE AND IN INDIANA: FAYETTE, FRANKLIN AND UNION. OHIO COUNTIES REPRESENT 63% OF THE SERVICE AREA WHILE INDIANA COUNTIES COMPRISE 37%.4. BASED ON THE DATA GATHERED, THE MAJOR NEEDS OF THE COMMUNITY SERVED BY MCCULLOUGH-HYDE MEMORIAL ARE ACCESS TO CARE AND OBESITY (INCLUDING RELATED ISSUES SUCH AS DIABETES AND HEART DISEASE).THE FULL TEXT OF THIS NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE. |
| PART VI, LINE 3: | FINANCIAL COUNSELORS ARE LOCATED IN THE PATIENT ACCESS AREAS AND PATIENTS ARE OFTEN REFERRED TO THEM AFTER THE COMPLETION OF THE REGISTRATION PROCESS. IN THE EVENT THAT FINANCIAL COUNSELORS ARE NOT AVAILABLE PATIENT ACCESS STAFF IS EDUCATED ON THE CHARITY CARE/FINANCIAL ASSISTANCE POLICIES AND HAVE APPLICATIONS AVAILABLE. CHARITY CARE INFORMATION IS ALSO INCLUDED ON OUR PATIENT STATEMENTS. ALL CUSTOMER SERVICE REPRESENTATIVES ARE FAMILIAR WITH OUR POLICIES AND CAN SPEAK TO OUR CUSTOMERS ABOUT CHARITY CARE/FINANCIAL ASSISTANCE ELIGIBILITY. BROCHURES EXPLAINING CHARITY CARE/FINANCIAL ASSISTANCE ARE ALSO AVAILABLE IN VARIOUS LOCATIONS THROUGHOUT THE HOSPITAL. |
| PART VI, LINE 4: | MCCULLOUGH HYDE MEMORIAL HOSPITAL SERVES A DIVERSE DEMOGRAPHIC INCLUDING THE NORTHWESTERN CORNER OF BUTLER COUNTY, OHIO, THE SOUTHWESTERN CORNER OF PREBLE COUNTY, OHIO AND THE COUNTIES OF FRANKLIN, UNION AND FAYETTE IN INDIANA. THE MAIN CAMPUS IS LOCATED IN OXFORD, OHIO, THE HOME OF MIAMI UNIVERSITY WITH A POPULATION RANGING TO NEARLY 30,000 DURING THE SCHOOL YEAR TO HALF THAT NUMBER DURING THE SUMMER.MHMH COUNTS ITS PRIMARY SERVICE AREA AS THE FOLLOWING: OXFORD,OH - 45056 - POPULATION 29,739 BROOKVILLE, IN - 47012 - POPULATION 10,455 COLLEGE CORNER, OH - 45003 - POPULATION 971 EATON, OH - 45320 - POPULATION 15,354 SOMERVILLE, OH - 45064 - 2,963 CAMDEN, OH - 45311 - 7,215 LIBERTY, IN - 47353 - 5,698 WEST COLLEGE CORNER, IN - 47003 - 834 TOTAL PRIMARY SERVICE AREA POPULATION = 73,229AND ITS SECONDARY SERVICE AREAS ARE THE FOLLOWING: HAMILTON, OH - 45013 - 54,814 CONNERSVILLE, IN - 47331 - 23,438 METAMORA, IN - 47030 - 1,631 OKEANA, OH - 45053 - 3,712 TOTAL SECONDARY SERVICE AREA POPULATION = 83,595IN TERMS OF SOCIO-ECONOMIC DEMOGRAPHICS, THE EDUCATIONAL ATTAINMENT IS LOWER THAN COUNTY, STATE AND NATIONAL AVERAGES AND THE UNEMPLOYMENT HIGHER THAN COUNTY, STATE AND NATIONAL AVERAGES IN ALL OF THE UNINCORPORATED AND RURAL AREAS SERVED BY MHMH. ALL OF THE AREAS IN INDIANA AND THE RURAL AREAS IN PREBLE AND BUTLER COUNTIES (CAMDEN, SOMERVILLE) ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS BY THE NATIONAL HEALTH SERVICE CORPS.MCCULLOUGH HYDE HAS RECRUITED, SUPPORTED AND WILL CONTINUE TO RECRUIT AND SUPPORT BOTH PRIMARY CARE PHYSICIANS AND SPECIALISTS TO MEET THE NEEDS OF RESIDENTS OF THESE COMMUNITIES. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| TALAWANDA ATHLETIC BOOSTERS | ||||||
| 5301 UNIVERSITY BLVD | OXFORD | OH | 45056 | 311062296 | $10,200 | SCHOOL PROGRAMS |
| SANE OF BUTLER COUNTY | ||||||
| PO BOX 18818 | FAIRFIELD | OH | 45018 | 311604036 | $7,500 | FORENSIC CARE |
| OXFORD FREE CLINIC | ||||||
| PO BOX 390 | OXFORD | OH | 45056 | 204253386 | $11,650 | COMMUNITY SUPPORT |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN HEHEMANN | ||||||||||||||
| CEO | $213,624 | $0 | $0 | $0 | $0 | $0 | $938 | $0 | $18,357 | $0 | $232,919 | $0 | $0 | $0 |
| JOHN CLEMENTS | ||||||||||||||
| VP & CFO | $146,434 | $0 | $0 | $0 | $0 | $0 | $938 | $0 | $7,970 | $0 | $155,342 | $0 | $0 | $0 |
| BRYAN MCCULLOUGH | ||||||||||||||
| PHYSICIAN | $577,486 | $0 | $0 | $0 | $0 | $0 | $938 | $0 | $29,086 | $0 | $607,510 | $0 | $0 | $0 |
| MARK CRISTELL | ||||||||||||||
| PT DIRECTOR | $128,283 | $0 | $9,536 | $0 | $0 | $0 | $938 | $0 | $19,027 | $0 | $157,784 | $0 | $0 | $0 |
| MATTHEW DAGGY | ||||||||||||||
| PHYSICIAN | $240,464 | $0 | $1,600 | $0 | $0 | $0 | $938 | $0 | $21,792 | $0 | $264,794 | $0 | $0 | $0 |
| PAUL CANGEMI | ||||||||||||||
| PHYSICIAN | $289,191 | $0 | $0 | $0 | $0 | $0 | $938 | $0 | $6,373 | $0 | $296,502 | $0 | $0 | $0 |
| GREGORY CALKINS | ||||||||||||||
| PHYSICIAN | $206,675 | $0 | $0 | $0 | $0 | $0 | $938 | $0 | $21,949 | $0 | $229,562 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | BRYAN HEHEMANN - NONQUALIFIED RETIREMENT PLAN FUNDED ANNUALLY - $15,000. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| BUTLER COUNTY-SERIES 2009A | |||||||
| A | 316000061 | 2013-09-19 | $10,314,685 | REFUNDING OF 2009 SERIES | 0 | 0 | 0 |
| BUTLER COUNTY-SERIES 2009B | |||||||
| B | 316000061 | 2013-09-19 | $3,131,352 | REFUNDING OF 2009 SERIES | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $10,437,650 | $10,314,685 | $64,196 | $187,162 | 2011 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $3,158,524 | $3,131,352 | $19,490 | $46,661 | 2011 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRYAN MCCULLOUGH | PersonNm |
| Relationship With Org | PHYSICIAN | RelationshipWithOrgTxt |
| Loan Purpose | BRIDGE LOAN | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $13,000 | OriginalPrincipalAmt |
| Balance Due | $13,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $13,000 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVE PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE SCOPE OF THIS POLICY INCLUDES HOSPITAL AND MEDICAL STAFF MEMBERS AND MEMBER OF THE BOARD OF DIRECTORS. THE POLICY IS IN PLACE TO PROTECT THE INTERESTS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL IN SITUATIONS WHERE INDIVIDUALS HAVE THE OPPORTUNITY TO ADVANCE THEIR OWN INTERESTS, OR THE INTERESTS OF OTHERS WITH WHOM THEY HAVE A RELATIONSHIP, IN A WAY THAT IS DETRIMENTAL TO THE INTEREST OF THE HOSPITAL. A SELF DISCLOSURE FORM IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSON COMPLETES THE CONFLICT OF INTEREST QUESTIONNAIRE AND SUBMITS IT TO THEIR DIRECT SUPERVISOR OR ADMINISTRATIVE REPRESENTATIVE, CORPORATE COMPLIANCE OFFICER OR THE COMPLIANCE COMMITTEE. THE ISSUE IS REVIEWED WITH ONE OF THE FOLLOWING WRITTEN RECOMMENDATIONS/CONCLUSIONS: 1) CIRCUMSTANCES DO NOT PRESENT A PROBLEM 2) ALTERNATE ARRANGEMENTS ARE MADE THAT ARE ACCEPTABLE TO THE INDIVIDUAL AND DO NOT PRESENT A PROBLEM OR 3) ALTERNATE ARRANGEMENTS ARE NOT ACCEPTABLE AND THE CONFLICT IS DEALT WITH ON AN INDIVIDUAL BASIS. THE COVERED PERSONS ARE REQUIRED TO REFRAIN FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS HAS RESPONSIBILITY FOR EXECUTIVE COMPENSATION STRUCTURES AND PROCESSES. THIS INCLUDES THE CEO AND OTHER OFFICIERS OF THE CORPORATION. THE COMMITTEE IS COMPRISED OF THE CHAIRPERSON OF THE BOARD AND TWO BOARD MEMBERS. FINDINGS AND RECOMMENDATIONS ARE REPORTED TO THE FULL BOARD OF DIRECTORS WHO HAS FINAL APPROVAL OF THE PLAN. THE COMPENSATION COMMITEE PERFORMS THE CEO EVALUATION WITH THE OVERALL RATING BEING USED IN DETERMINING COMPENSATION ALONG WITH AVAILABLE MARKET DATA. MARKET DATA IS COMPLIED BY THE DIRECTOR OF HUMAN RESOURCES AND PRESENTED TO THE COMMITTEE. A WRITTEN RECORD OF THE EVALUATION RESULTS, COMPARABILITY DATA AND THE CONCLUSIONS/RECOMMENDATION OF THE COMMITTEE ARE MAINTAINED AND PRESENTED TO THE FULL BOARD OF DIRECTORS. THE FINAL DECISION OF THE BOARD IS DOCUMENTED IN BOARD MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, THE FINANCIAL STATEMENTS ARE PRESENTED TO THE CITY OF OXFORD ANNUALLY AT A MEETING THAT IS OPEN TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,287,076. MANAGEMENT AND GENERAL EXPENSES 2,346,989. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,634,065. |
| FORM 990 PAGE 10 PART X LINE 11G | CONTRACTED WAGES = $2,305,387 PURCHASED SERVICES = $4,141,954 |
| FORM 990, PART XI, LINE 9: | EXPENSES ALLOCATED TO 990T -199,177. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237374256 | EIN |
| Primary Activities | OBTAIN CHARITABLE CONTRIBUTIONS, MANAGE THEM AND DISBURSE BY BOARD DIRECTION | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 11A, I | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT | ||
| C | $136,175 | ACTUAL |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT | ||
| Q | $284,138 | ACTUAL |
Comments