CUMBERLAND MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CUMBERLAND MEDICAL CENTER INC (EIN 62-0790132)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-01-15
- IRS object ID
- 201430179349300428
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-01-15T12:27:22-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621046406 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON HICKEY & MURCHISON PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 651 E 4TH ST STE 200 | AddressLine1 |
| City | CHATTANOOGA | City |
| State | TN | State |
| ZIP Code | 37403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 620790132 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CUMBERLAND MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CUMB | NameControl |
| Phone | 9314849511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 SOUTH MAIN STREET | AddressLine1 |
| City | CROSSVILLE | City |
| State | TN | State |
| ZIP Code | 38555 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LARRY E MOORE | Name |
| Title | CFO | Title |
| Phone | 9314849511 | Phone |
| Date Signed | 2014-01-17 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BARRY R HUGGINS | Name |
| PTIN | P00627334 | PTIN |
| Phone | 4237560052 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY E MOORE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 SOUTH MAIN STREET | AddressLine1 |
| City | CROSSVILLE | City |
| State | TN | State |
| ZIP Code | 38555 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 104592254 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CMCHEALTHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | TN | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION IS TO MAKE AVAILABLE QUALITY HEALTH CARE ON A REGIONAL LEVEL TO THOSE IN NEED OF ITS SERVICE THROUGH DEDICATION, PROFESSIONALISM AND FINANCIAL STABILITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1285 | TotalNbrEmployees |
| Total Nbr Volunteers | 143 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 161654 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 67721 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 106710289 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 100950037 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 338109 | InvestmentIncomePriorYear |
| Investment Income Current Year | 302817 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 429889 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3271679 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 107639941 | TotalRevenuePriorYear |
| Total Revenue Current Year | 104592254 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 51592457 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 50625449 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 54007621 | OtherExpensePriorYear |
| Other Expenses Current Year | 54539082 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 105600078 | TotalExpensesPriorYear |
| Total Expenses Current Year | 105164531 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2039863 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -572277 | RevenuesLessExpensesCY |
| Total Assets BOY | 124330508 | TotalAssetsBOY |
| Total Assets EOY | 123037648 | TotalAssetsEOY |
| Total Liabilities BOY | 52937183 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 51172605 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 71393325 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 71865043 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION IS TO MAKE AVAILABLE QUALITY HEALTH CARE ON A REGIONAL LEVEL TO THOSE IN NEED OF ITS SERVICE THROUGH DEDICATION, PROFESSIONALISM AND FINANCIAL STABILITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8560297 | Expense |
| Revenue | 19601837 | Revenue |
| Description | INPATIENT ROUTINE CARE SERVICES TO INCLUDE NURSING, MEALS, HOUSEKEEPING, ETC. FOR 22,652 ROUTINE INPATIENT DAYS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6508226 | Expense |
| Revenue | 26835163 | Revenue |
| Description | CUMBERLAND MEDICAL CENTER PERFORMED 10,003 SURGICAL PROCEDURES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4702272 | Expense |
| Revenue | 18066613 | Revenue |
| Description | CUMBERLAND MEDICAL CENTERS DISPENSED 859,652 PHARMACY DOSES. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 73013172 | Expense |
| Revenue | 39721269 | Revenue |
| Description | ALL OTHER ROUTINE AND NECESSARY EXPENSES TO PROVIDE HEALTHCARE SERVICES IN AN ACUTE CARE HOSPITAL WITH 145 ROUTINE BEDS, 12 INTENSIVE CARE UNIT BEDS, 14 NURSERY BEDS, AND 12 REHABILITATION UNIT BEDS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 73013172 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 39721269 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 92783967 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 76 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1285 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | TN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LARRY MOORE CFO | NamePerson |
| Telephone Number | 9314849511 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 S MAIN STREET | AddressLine1 |
| City | CROSSVILLE | City |
| State | TN | State |
| ZIP Code | 38555 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| REYNALDO OLAECHEA | ||||||||
| DIRECTOR | 40.00 | X | 176434 | 0 | 12673 | |||
| BETH PETTY MD | ||||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |||
| COSBY A STONE | ||||||||
| CHAIRMAN, EXECUTIVE COMMIT | 0.00 | X | 0 | 0 | 0 | X | ||
| JW BROWN | ||||||||
| CHAIRMAN EMERITUS | 0.00 | X | 0 | 0 | 0 | X | ||
| JAMES BARNAWELL MD | ||||||||
| CHAIRMAN | 40.00 | X | 323554 | 0 | 0 | X | ||
| SALLY OGLESBY | ||||||||
| SECRETARY | 0.00 | X | 0 | 0 | 0 | X | ||
| LARRY REED MD | ||||||||
| DIRECTOR | 40.00 | X | 17100 | 0 | 0 | |||
| ED CAMERA | ||||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |||
| ROY HOWARD | ||||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |||
| ROBERT HARRISON | ||||||||
| VICE CHAIR | 0.00 | X | 0 | 0 | 0 | X | ||
| LARRY MOORE | ||||||||
| CFO | 40.00 | 250925 | 0 | 2328 | X | |||
| SIVALINGAM KANAGASEGAR MD | ||||||||
| PHYSICIAN | 40.00 | 334949 | 0 | 18536 | X | |||
| ERNEST M MAK MD | ||||||||
| PHYSICIAN | 40.00 | 271046 | 0 | 13373 | X | |||
| ELIS ABOU-ZEID MD | ||||||||
| PHYSICIAN | 40.00 | 261816 | 0 | 7376 | X | |||
| LANA JERADEH-BOURSOULIAN MD | ||||||||
| PHYSICIAN | 40.00 | 246336 | 0 | 12194 | X | |||
| JAMES S JOHNSON MD | ||||||||
| PHYSICIAN | 40.00 | 273055 | 0 | 18536 | X | |||
| BARRY S WAGNER MD | ||||||||
| CHIEF EXECUTIVE OFFICER FORMER | 40.00 | 154855 | 0 | 2391 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2310070 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 87407 | TotalOtherCompensation |
| Number Individuals GT100 K | 29 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CUMBERLAND ANESTHESIA GROUP LLC | |||||
| PO BOX 88544 | MILWAUKEE | WI | 53288 | CONTRACT ANESTHESIA | 1178483 |
| JAMES BARNWELL MD | |||||
| 421 SOUTH MAIN STREET | CROSSVILLE | TN | 38555 | PATHOLOGY | 323354 |
| MOBILE TECH SVC | |||||
| 201 NORTH WHITE 1 | ATHENS | TN | 37303 | MOBILE PET/CT | 320450 |
| DR JOHN MILLIGAN | |||||
| 61 FLAMINGO DRIVE | CROSSVILLE | TN | 38555 | PROFESSIONAL LIABILITY INS./PHYSICIANS G | 305279 |
| BIO-MEDICAL APPLICATIONS OF TN | |||||
| PO BOX 101518 | ATLANTA | GA | 30392 | SOFTWARE | 196975 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Government Grants | 66721 | GovernmentGrants |
| All Other Contributions | 1000 | AllOtherContributions |
| Total Contributions | 67721 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 100950037 | TotalRevenueColumn |
| Related Or Exempt Function Income | 100950037 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 100950037 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 299651 | TotalRevenueColumn |
| Exclusion | $299,651 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 362617 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 362617 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 362617 | TotalRevenueColumn |
| Related Or Exempt Function Income | 362617 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3166 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3166 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3166 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3166 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| ELECTRONIC HEALTH RECORD INCENTIV | 621990 | 2718441 | 2718441 |
| MISCELLANEOUS REVENUE | 621990 | 190621 | 190621 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2909062 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 104592254 | TotalRevenueColumn |
| Related Or Exempt Function Income | 104224882 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $299,651 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 489538 | Total |
| Management And General | 489538 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40543400 | Total |
| Program Services | 33236680 | ProgramServices |
| Management And General | 7306720 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350198 | Total |
| Program Services | 283660 | ProgramServices |
| Management And General | 66538 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6393152 | Total |
| Program Services | 5178453 | ProgramServices |
| Management And General | 1214699 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2849161 | Total |
| Program Services | 2307820 | ProgramServices |
| Management And General | 541341 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1959049 | Total |
| Program Services | 1586830 | ProgramServices |
| Management And General | 372219 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63696 | Total |
| Program Services | 51594 | ProgramServices |
| Management And General | 12102 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48392 | Total |
| Program Services | 48392 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7003838 | Total |
| Program Services | 7003838 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1397274 | Total |
| Program Services | 1397274 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 201837 | Total |
| Program Services | 201837 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119073 | Total |
| Program Services | 119073 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4157768 | Total |
| Program Services | 3367792 | ProgramServices |
| Management And General | 789976 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150496 | Total |
| Program Services | 121902 | ProgramServices |
| Management And General | 28594 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2029669 | Total |
| Program Services | 2029669 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6236072 | Total |
| Program Services | 6236072 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2488615 | Total |
| Program Services | 2488615 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES AND DR | 11830183 | 11830183 | |
| BAD DEBTS | 8902360 | 8902360 | |
| TAX & LICENSES | 4022848 | 3258507 | 764341 |
| OTHER EXPENSES | 2796738 | 2247742 | 548996 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1131174 | Total |
| Program Services | 885674 | ProgramServices |
| Management And General | 245500 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105164531 | Total |
| Program Services | 92783967 | ProgramServices |
| Management And General | 12380564 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22024303 | BOY |
| EOY | 7108019 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3527767 | BOY |
| EOY | 3738871 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15869091 | BOY |
| EOY | 14199111 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1882 | BOY |
| EOY | 254856 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1735459 | BOY |
| EOY | 1885539 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1086211 | BOY |
| EOY | 1037672 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 152226133 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 74137105 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76895440 | BOY |
| EOY | 78089028 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 805510 | BOY |
| EOY | 210761 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2384845 | BOY |
| EOY | 16513791 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124330508 | BOY |
| EOY | 123037648 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8081655 | BOY |
| EOY | 7482198 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40138718 | BOY |
| EOY | 40017750 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4716810 | BOY |
| EOY | 3672657 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52937183 | BOY |
| EOY | 51172605 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71231631 | BOY |
| EOY | 71717738 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161694 | BOY |
| EOY | 147305 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71393325 | BOY |
| EOY | 71865043 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124330508 | BOY |
| EOY | 123037648 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -572277 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1043995 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2754819 | OtherCostOrOtherBasis |
| Book Value | 2754819 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 87196328 | OtherCostOrOtherBasis |
| Depreciation | 29950583 | Depreciation |
| Book Value | 57245745 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58426234 | OtherCostOrOtherBasis |
| Depreciation | 43244364 | Depreciation |
| Book Value | 15181870 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3848752 | OtherCostOrOtherBasis |
| Depreciation | 942158 | Depreciation |
| Book Value | 2906594 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 78089028 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BOND ISSURANCE COSTS | 49779 |
| GOODWILL | 533392 |
| OTHER ASSETS | 740517 |
| ASSETS INTERNALLY DESIGNATED FOR CAPITAL IMPROVEMENTS | 15042798 |
| CASH LIMITED TO SPECIAL OPERATIONS | 82299 |
| INVESTMENTS FOR SPECIAL PROJECTS | 65006 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 16513791 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| SWAP AGREEMENT LIABILITY | $3,247,413 |
| CMC CAPITAL LEASE LIABILITY | $402,336 |
| CMC MOB SECURITY DEPOSITS | $22,908 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3672657 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 105636249 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 1043995 | OtherRevenues |
| Revenue Not Rptd F990 | 1043995 | RevenueNotRptdF990 |
| Revenue Subtotal | 104592254 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 104592254 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 105164531 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 105164531 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 105164531 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE MEDICAL CENTER ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740-10 "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES." ASC 740-10 PROVIDES GUIDANCE ON DERECOGNITION OF TAX BENEFITS, CLASSIFICATION ON THE BALANCE SHEET, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE MEDICAL CENTER BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. AS OF JUNE 30, 2013 AND 2012, THE MEDICAL CENTER DID NOT RECORD ANY INTEREST OR PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS THE MEDICAL CENTER'S FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, FOR THE YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | UNREALIZED GAIN ON SWAP AGREEMENT 1,125,300. UNREALIZED LOSSES ON OTHER THAN TRADING SECURITIES -22,501. EXCESS OF CONSIDERATION PAID IN EXCESS OF VALUE IN ACQUISITION -66,162. CHANGE IN RESTRICTED ASSETS 7,358. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 608289 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 608289 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00630 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12659932 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6084910 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6575022 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06830 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13268221 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6084910 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7183311 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07460 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 553784 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1548 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 552236 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00570 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6349423 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4691553 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1657870 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01720 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29890 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 29890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6933097 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4693101 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2239996 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02320 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20201318 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10778011 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9423307 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09780 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $8,902,360 | BadDebtExpenseAmount |
| Amount Attributable To | 3203861 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 37828042 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 36646164 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1181878 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 CST COMM HEALTH LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | HEALTHCARE SERVICES/CARDIAC CATH | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 1.00000 | OrganizationProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CUMBERLAND MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 S MAIN ST | AddressLine1 |
| City | CROSSVILLE | City |
| State | TN | State |
| ZIP Code | 38555 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | HOSPITAL | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CUMBERLAND MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 0 | CHNAWidelyAvailable |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 10 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (10 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CMC HOME CARE | ||||
| 79 S MAIN ST | CROSSVILLE | TN | 38555 | HOME HEALTH AGENCY |
| CUMBERLAND PHYSICAL REHAB UNIT | ||||
| 421 S MAIN ST | CROSSVILLE | TN | 38555 | INPATIENT REHABILITATION FACILITY |
| CUMBERLAND PHYSICIANS GROUP | ||||
| 133 HAYES ST | CROSSVILLE | TN | 38555 | GEN. AND SPECIALTY PHYSICIANS |
| CMC WELLNESS COMPLEX | ||||
| 130 WOODMERE MALL | CROSSVILLE | TN | 38555 | WELLNESS AND DIABETES MANAGEMENT |
| CUMBERLAND MEDICAL CENTER AT FFG | ||||
| 130 STONEHENGE DR | CROSSVILLE | TN | 38555 | WELLNESS, PHYSICAL THERAPY, & MAMMOGRAPHY |
| CMC OUTPATIENT IMAGING CENTER | ||||
| 28 HAYES ST | CROSSVILLE | TN | 38555 | MEDICAL IMAGING AND PET SCAN |
| CMC MEDICAL EQUIPMENT SERVICES | ||||
| 591 S MAIN ST | CROSSVILLE | TN | 38555 | MEDICAL EQUIPMENT AND OXYGEN |
| CMC CANCER CENTER | ||||
| 421 S MAIN ST | CROSSVILLE | TN | 38555 | ONCOLOGY RADIATION THERAPY |
| CMC OCCUPATIONAL MEDICINE | ||||
| 44 HAYES ST SUITE 202 | CROSSVILLE | TN | 38555 | WORK RELATED CARE AND EXAMS |
| CMC WOUND CENTER | ||||
| 421 S MAIN ST | CROSSVILLE | TN | 38555 | WOUND AND HYPERBARIC TREATMENT |
Form990 Schedule H Part VI Form990ScheduleHPartVI (5 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 7: LINE 7E - COMMUNITY HEALTH IMPROVEMENT AND BENEFIT OPERATIONSTHE COST OF $552,236 FOR COMMUNITY HEALTH IMPROVEMENT AND BENEFIT OPERATIONS WAS PROVIDED BY VARIOUS OPERATIONS INCLUDING:BLOOD PRESSURE CHECKS AND VARIOUS VOLUNTEER SERVICES AT THE SENIOR CITIZEN CENTERSERVICES PROVIDED TO THE BREAD OF LIFE MISSION CLINICRELAY FOR LIFE AND HEART WALKCOLON CANCER SCREENING AND CONSULTATIONGRIEF AND CPAP SUPPORT GROUPSPROVIDING COMMUNITY HEALTH FAIRSPROVIDING MEDICAL EDUCATION SEMINARS |
| PART I, LINE 7G: SUBSIZIDED HEALTH SERVICESTHE SUBSIDY OF $1,657,870 IS THE DIFFERENCE BETWEEN THE COST OF SERVICES PROVIDED IN THE HOSPITAL'S PHYSICIAN OFFICES, WOUND CARE CENTER, AND SENIOR PERSPECTIVES AND THE PAYMENTS RECEIVED FOR THOSE SERVICES. THE PHYSICIAN OFFICES INCLUDE FAMILY, INTERNAL MEDICINE, OB/GYN, SURGEONS, AND OTHER SPECIALTY PHYSICIANS. ALTHOUGH PATIENTS WITH MEDICARE OR COMMERCIAL INSURANCE COVERAGE ARE PROVIDED SERVICES, THESE PHYSICIAN OFFICES WERE ESTABLISHED TO PROVIDE SERVICES FOR PATIENTS WITHOUT INSURANCE COVERAGE OR WITH TENNCARE/MEDICAID. THE COST OF PROVIDING THESE SERVICES EXCEEDED THE PAYMENTS RECEIVED BY $1,505,872 DURING THE REPORTING PERIOD.THE WOUND CARE CENTER PROVIDES HYPERBARIC AND WOUND TREATMENT SERVICES. THE COST OF PROVIDING SERVICES EXCEEDED REVENUE BY $176,199 SENIOR PERSPECTIVES PROVIDES BEHAVIORAL HEALTH SERVICES TO SENIOR CITIZENS. REVENUE FOR THESE SERVICES EXCEEDED THE COST RECEIVED BY $14,327 DURING THE REPORTING PERIOD. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 8902360. |
| PART III, LINE 4: THE MEDICAL CENTER MAINTAINS ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE INABILITY OF ITS PATIENTS TO MAKE PAYMENTS. MANAGEMENT CONSIDERS THE FOLLOWING FACTORS WHEN DETERMINING THE COLLECTIBILITY OF PATIENT ACCOUNTS: PAYOR CREDIT-WORTHINESS, PAST TRANSACTION HISTORY WITH THE PAYOR, CURRENT ECONOMIC INDUSTRY TRENDS, AND CHANGES IN PAYOR PAYMENT TERMS. IF THE FINANCIAL CONDITION OF THE MEDICAL CENTER'S PAYORS OR PATIENTS WERE TO DETERIORATE, ADVERSELY AFFECTING THEIR ABILITY TO MAKE PAYMENTS, ADDITIONAL ALLOWWANCES WOULD BE REQUIRED. BASED ON MANAGEMENT'S ASSESSMENT, THE MEDICAL CENTER PROVIDES FOR ESTIMATED UNCOLLECTABLE AMOUNTS THROUGH A CHARGE TO EARNINGS AND A CREDIT TO AN ALLOWANCE. BALANCES THAT REMAIN OUTSTANDING AFTER THE MEDICAL CENTER HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.THE ESTIMATED AMOUNT OF THE MEDICAL CENTER'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS 7.2% OF THE TOTAL BAD DEBT EXPENSE. THIS IS BASED ON THE PERCENT OF THE POPULATION IN CUMBERLAND COUNTY IN 2010 THAT IS LIVING IN POVERTY (SOURCE HTTP://WWW.ERS.USDA.GOV/DATA-PRODUCTS/COUNTY-LEVEL-DATA-SETS/POVERTY.ASPX). SINCE THE MEDICAL CENTER PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO EXCEED THE FEDERAL POVERTY LEVEL BY 150 - 200%, THIS PERCENT IS A CONSERVATIVE ESTIMATE. |
| PART III, LINE 8: CUMBERLAND MEDICAL CENTER IS AN ACUTE CARE MEDICAL/SURGICAL FACILITY WHICH SERVES A LARGE TENNCARE AND MEDICARE POPULATION. WITH THIS DEMOGRAPHIC COMES THE REALIZATION OF LOW REIMBURSEMENT, BAD DEBT, AND MEDICARE SHORTFALLS. IN OUR AREA OF THE COUNTRY AND ESPECIALLY OUR AREA OF THE STATE, IT IS PART OF PROVIDING HEALTHCARE TO OUR PATIENTS. WE CONSIDER A LARGE PART OF WHAT WE "WRITE-OFF" EACH YEAR AND THE MONEY THAT WE WILL NEVER SEE AS INCOME TO OUR BOTTOM LINE AS A BENEFIT THAT WE GIVE BACK TO OUR COMMUNNITY. IT IS A SERVICE THAT WE ARE PROVIDING TO THOSE WHO CANNOT PROVIDE FOR THEMSELVES. OUR MISSION STATES THAT WE WILL MAKE AVAILABLE QUALITY HEALTH CARE ON A REGIONAL LEVEL TO THOSE IN NEED OF ITS SERVICES THROUGH DEDICATION, PROFESSIONALISM, AND FINANCIAL STABILITY. WHILE IT IS OUR FIDUCIARY RESPONSIBILITY TO MANAGE OUR FACILITY, IT IS OUR FIRST CONCERN TO CARE FOR THE PATIENT'S HEALTH AND WELL BEING. THE DIFFERENCE BETWEEN THOSE IN A COMMUNITY LIKE OURS WHEN ABSORBED BY THE HOSPITAL IS MOST DEFINITELY BENEFITTING THE COMMUNITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REYNALDO OLAECHEA | ||||||||||||||
| DIRECTOR | 176434 | 0 | 0 | 0 | 0 | 0 | 1750 | 0 | 10923 | 0 | 189107 | 0 | 0 | 0 |
| JAMES BARNAWELL MD | ||||||||||||||
| CHAIRMAN | 323554 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 323554 | 0 | 0 | 0 |
| LARRY MOORE | ||||||||||||||
| CFO | 250925 | 0 | 0 | 0 | 0 | 0 | 1360 | 0 | 968 | 0 | 253253 | 0 | 0 | 0 |
| SIVALINGAM KANAGASEGAR MD | ||||||||||||||
| PHYSICIAN | 334949 | 0 | 0 | 0 | 0 | 0 | 2450 | 0 | 16086 | 0 | 353485 | 0 | 0 | 0 |
| ERNEST M MAK MD | ||||||||||||||
| PHYSICIAN | 271046 | 0 | 0 | 0 | 0 | 0 | 2450 | 0 | 10923 | 0 | 284419 | 0 | 0 | 0 |
| ELIS ABOU-ZEID MD | ||||||||||||||
| PHYSICIAN | 261816 | 0 | 0 | 0 | 0 | 0 | 591 | 0 | 6785 | 0 | 269192 | 0 | 0 | 0 |
| LANA JERADEH-BOURSOULIAN MD | ||||||||||||||
| PHYSICIAN | 246336 | 0 | 0 | 0 | 0 | 0 | 622 | 0 | 11572 | 0 | 258530 | 0 | 0 | 0 |
| JAMES S JOHNSON MD | ||||||||||||||
| PHYSICIAN | 273055 | 0 | 0 | 0 | 0 | 0 | 2450 | 0 | 16086 | 0 | 291591 | 0 | 0 | 0 |
| BARRY S WAGNER MD | ||||||||||||||
| CHIEF EXECUTIVE OFFICER FORMER | 154855 | 0 | 0 | 0 | 0 | 0 | 1544 | 0 | 847 | 0 | 157246 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 5 | COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION: LISTED EMPLOYED PHYSICIANS RECEIVE AN INCENTIVE BONUS EQUAL TO A PERCENTAGE OF CASH COLLECTIONS FROM THEIR OWN PRACTICE GREATER THAN THE PHYSICIAN'S ANNUAL SALARY. |
| PART I, LINE 6 | PAID COMPENSATION CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION: THE PRESIDENT/CEO AND OTHER OFFICERS RECEIVE AN INCENTIVE BONUS BASED ON VARIOUS CRITERIA, INCLUDING A COMPARISON OF ACTUAL NET EARNINGS TO BUDGETED NET EARNINGS. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH & ED FAC BD OF THE CITY OF CROSSVILLE TN REV REFUND BONDS SER 2012 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 581799575 | IssuerEIN |
| Date Issued | 2012-05-01 | DateIssued |
| Issue Price | 40017750 | IssuePrice |
| Description Of Purpose | PAYOFF PREVIOUSLY ISSUED BONDS | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 39967221 | AmountRetired |
| Total Proceeds | 40017750 | TotalProceeds |
| Issuance Costs From Proceeds | 50529 | IssuanceCostsFromProceeds |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 1 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONS BANK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 5.000000000000 | TermOfHedge |
| Superintegrated Hedge | 1 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT AND THE BOARD OF DIRECTORS WILL REVIEW THE 990 BEFORE IT IS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | CUMBERLAND MEDICAL CENTER'S CONFLICT OF INTEREST STATEMENT IS DISCUSSED AND REVIEWED WITH POTENTIAL APPLICANTS FOR EMPLOYMENT DURING THE INTERVIEW PROCESS, WITH NEW EMPLOYEES DURING A NEW EMPLOYEE ORIENTATION AS WELL AS DURING DEPARTMENTAL ORIENTATION AND ANNUALLY FOR ALL EMPLOYEES DURING EACH EMPLOYEE'S ANNUAL PERFORMANCE REVIEW. IF NO CONFLICT OF INTEREST IS IDENTIFIED, IT IS NOTED ON THE CONFLICT OF INTEREST STATEMENT, SIGNED BY THE EMPLOYEE, AND PLACED IN THE EMPLOYEE'S FILE. IF A CONFLICT OF INTEREST IS IDENTIFIED, AFTER DISCUSSION AND REVIEW BY A CORPORATE OFFICER AND/OR OTHER ADDITIONAL INPUT AS NECESSARY, APPROPRIATE ACTION IS TAKEN UP TO AND INCLUDING TERMINATION OF EMPLOYMENT WITH CUMBERLAND MEDICAL CENTER OR THE OTHER EMPLOYER THAT IS CAUSING THE CONFLICT OF INTEREST. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO REVIEW COMMITTEE AND THE EXECUTIVE COMPENSATION COMMITTEE REVIEW THE PERFORMANCE AND SALARY OF THE CEO ANNUALLY. THE COMMITTEES ARE APPOINTED ANNUALLY BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. TENNESSEE HOSPITAL ASSOCIATION SALARY SURVEY INFORMATION IS PROVIDED FOR REVIEW. DUE TO BUDGET CONSTRAINTS, NO WAGE INCREASE WAS PROVIDED DURING THE YEAR. THE PRESIDENT/CEO REVIEWS THE PERFORMANCE AND SALARY OF THE OFFICERS. TENNESSEE HOSPITAL ASSOCIATION SALARY SURVEY INFORMATION IS PROVIDED FOR REVIEW. DUE TO BUDGET CONSTRAINTS, NO WAGE INCREASES FOR OFFICERS WERE PROVIDED DURING THE YEAR. | |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART XI, LINE 9: | UNREALIZED GAIN ON SWAP AGREEMENT 1,125,300. UNREALIZED LOSS ON OTHER THAN TRADING SECURITIES -22,501. NET CHANGE IN TEMPORARILY RESTRICTED ASSETS -21,748. EXCESS OF CONSIDERATION PAID FOR ACQUISITION -66,162. NET ASSETS RELEASED FROM RESTRICTIONS 21,748. OTHER CHANGES IN ASSETS 7,358. | CHANGES IN NET ASSETS OR FUND BALANCES: |