MIDDLE MACOUPIN HEALTH CARE SYSTEMS: Form 990EZ, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MIDDLE MACOUPIN HEALTH CARE SYSTEMS (EIN 37-1193396)
Tax period
2012-08-01 to 2013-07-31
Filed
2014-03-11
IRS object ID
201410709349200731
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-03-11T16:30:34-05:00Timestamp
Tax Period End Date2013-07-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13999 PENNSYLVANIA AVE SUITE 100AddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52002ZIPCode
FieldValueIRS element (for citing)
Return Type990EZReturnType
Tax Period Begin Date2012-08-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN371193396EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Middle Macoupin Healthcare SystemsBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMIDDNameControl
Phone2178543141Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line120733 North Broad StreetAddressLine1
CityCarlinvilleCity
StateILState
ZIP Code62626ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKenneth ReidName
TitleCarlinville Area Hospital CEOTitle
Phone2178543141Phone
Date Signed2014-03-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCarmen KrantzName
PTINP00031958PTIN
Phone5635561790Phone
Date Prepared2014-03-07DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Schedule B Not RequiredXScheduleBNotRequired
Web SiteN/AWebSite
Organization501c3XOrganization501c3
Gross Receipts Less Than25000XGrossReceiptsLessThan25000
Gross Receipts0GrossReceipts
Net Assets Or Fund Balances BOY44NetAssetsOrFundBalancesBOY
Other Changes In Net Assets0OtherChangesInNetAssets
Net Assets Or Fund Balances EOY44NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIXInfoInScheduleOPartII

Cash Savings And Investments CashSavingsAndInvestments

FieldValueIRS element (for citing)
BOY44BOY
EOY44EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY246EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY44BOY
EOY290EOY

Sum Of Total Liabilities SumOfTotalLiabilities

FieldValueIRS element (for citing)
EOY246EOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

FieldValueIRS element (for citing)
BOY44BOY
EOY44EOY
FieldValueIRS element (for citing)
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Primary Exempt PurposeProvide support and benefit Carlinville Area Hospital AssociationPrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment

FieldValueIRS element (for citing)
Description Program Service AccomTo operate for the benefit of, support, promote, advance and strengthen Carlinville Area Hospital Association in the promotion of wellness and in charitable fundraising in and around the greater Carlinville area and the Association's service area.DescriptionProgramServiceAccom
Grants And Allocations0GrantsAndAllocations
Program Service Expenses0ProgramServiceExpenses

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (8 entries)

TitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
J Richard Schien
Chairman0.25000
James Salske
Vice Chairman0.25000
Ralph March
Secretary0.25000
Dennis Pickrel
Treasurer0.25000
Richard Walden
Member0.25000
Kenneth Reid
CEO-Carlinville Hospital0.25000
Greg Ward
CFO-Hospital until Jan 20130.25000
Michael Brown
CFO-Hospital commenced April 20130.25000
FieldValueIRS element (for citing)
Info In Schedule O Part VXInfoInScheduleOPartV
Activities Not Previously Rpt0ActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc Doc0MadeChangesToOrgnzngEtcDoc
Organization Had UBI0OrganizationHadUBI
Subject To Proxy Tax0SubjectToProxyTax
Organization Dissolved Etc0OrganizationDissolvedEtc
Direct Indirect Political Expend0DirectIndirectPoliticalExpend
Made Loans To From Officers0MadeLoansToFromOfficers
Tax Imposed Under IRC49110TaxImposedUnderIRC4911
Tax Imposed Under IRC49120TaxImposedUnderIRC4912
Tax Imposed Under IRC49550TaxImposedUnderIRC4955
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTrans
Amount Of Tax Imposed On Org Mgr0AmountOfTaxImposedOnOrgMgr
Amount Of Tax Reimbursed By Org0AmountOfTaxReimbursedByOrg
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Michael BrownBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line120733 North Broad StreetAddressLine1
CityCarlinvilleCity
StateILState
ZIP Code62626ZIPCode
FieldValueIRS element (for citing)
Telephone Number2178543857TelephoneNumber
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccount
Foreign Office0ForeignOffice
Maintain Any Donor Advised Funds0MaintainAnyDonorAdvisedFunds
Does Org Have Hospital0DoesOrgHaveHospital
Tanning Services Provided0TanningServicesProvided
Related Org Controlled Entity0RelatedOrgControlledEntity
Engage Political Cmpgn Activities0EngagePoliticalCmpgnActivities
Engage In Lobbying Activities0EngageInLobbyingActivities
Operating School0OperatingSchool
Trnsfrs Exempt Non Char Related Org0TrnsfrsExemptNonCharRelatedOrg
Part VI Of Comp Of Highest Paid EmplNONEPartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof SerNONEPartVIAHghstPaidCntrctProfSer
Filed Schedule A1FiledScheduleA

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Carlinville Area Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
EIN370645239EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Other AssetsForm 990-EZ, Part II, Line 24Description: Due from affiliate. Beg. of Year Amount: 0. End of Year Amount: 246.
Other LiabilitiesForm 990-EZ, Part II, Line 26Description: Due to affiliate. Beg. of Year Amount: 0. End of Year Amount: 246.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationThe organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract.Declaration

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