FURP.ORG / PUBLIC DATA EXPLORER

SWEETWATER HOSPITAL ASSOCIATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SWEETWATER HOSPITAL ASSOCIATION (EIN 62-0544855)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-04-03
IRS object ID
201430939349300218
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)
Timestamp2014-04-03T12:15:37-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN621046406EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON HICKEY & MURCHISON PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1651 E 4TH ST STE 200AddressLine1
CityCHATTANOOGACity
StateTNState
ZIP Code37403ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN620544855EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SWEETWATER HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSWEENameControl
Phone8652138200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1304 CHURCH STREETAddressLine1
CitySWEETWATERCity
StateTNState
ZIP Code37874ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSCOTT BOWMANName
TitleSECRETARY TREASURERTitle
Phone8652138200Phone
Date Signed2014-03-19DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBARRY R HUGGINSName
PTINP00627334PTIN
Phone4237560052Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSCOTT BOWMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1304 CHURCH STREETAddressLine1
CitySWEETWATERCity
StateTNState
ZIP Code37874ZIPCode
FieldValueIRS element (for citing)
Gross Receipts57367296GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SWEETWATERHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1934YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF THE SWEETWATER HOSPITAL ASSOCIATION IS TO PROMOTE HEALTHY LIFESTYLES AND TO PROVIDE THE HIGHEST QUALITY PRIMARY HEALTH CARE TO THE REGION AT THE LOWEST POSSIBLE COST.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees573TotalNbrEmployees
Total Nbr Volunteers25TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2075ContributionsGrantsPriorYear
Contributions Grants Current Year2725ContributionsGrantsCurrentYear
Program Service Revenue Prior Year56452948ProgramServiceRevenuePriorYear
Program Service Revenue CY56766965ProgramServiceRevenueCY
Investment Income Prior Year122502InvestmentIncomePriorYear
Investment Income Current Year68376InvestmentIncomeCurrentYear
Other Revenue Prior Year447967OtherRevenuePriorYear
Other Revenue Current Year527954OtherRevenueCurrentYear
Total Revenue Prior Year57025492TotalRevenuePriorYear
Total Revenue Current Year57366020TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year19732694SalariesEtcPriorYear
Salaries Etc Current Year20224909SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year28428976OtherExpensePriorYear
Other Expenses Current Year30340622OtherExpensesCurrentYear
Total Expenses Prior Year48161670TotalExpensesPriorYear
Total Expenses Current Year50565531TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8863822RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6800489RevenuesLessExpensesCY
Total Assets BOY56017648TotalAssetsBOY
Total Assets EOY64012662TotalAssetsEOY
Total Liabilities BOY3413284TotalLiabilitiesBOY
Total Liabilities EOY4611568TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY52604364NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY59401094NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF THE SWEETWATER HOSPITAL ASSOCIATION IS TO PROMOTE HEALTHY LIFESTYLES AND TO PROVIDE THE HIGHEST QUALITY PRIMARY HEALTHCARE TO THE REGION AT THE LOWEST POSSIBLE COST.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5498472Expense
Revenue7195738Revenue
DescriptionPROVIDED FOR 294,532 LABORATORY TESTS DURING THE FISCAL YEAR ENDING 6/30/13Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense13792996Expense
Revenue18050614Revenue
DescriptionPROVIDED FOR 21,944 EMERGENCY ROOM VISITS DURING THE FISCAL YEAR ENDING 6/30/2013Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense9088105Expense
Revenue11893418Revenue
DescriptionPROVIDED FOR 66,367 X-RAY PROCEDURES DURING THE FISCAL YEAR ENDING 6/30/13Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense15404110Expense
Revenue20155149Revenue
DescriptionALL OTHER SERVICES INCLUDE PHARMACY, ROUTINE CARE, OPERATING ROOM, MEDICAL SUPPLIES, THERAPY, HOME HEALTHCARE, LABOR AND DELIVERY. LESS CONTRACTUAL ADUSTMENTS AND POLICY DISCOUNTSDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp15404110TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev20155149TotalOfOtherProgramServiceRev
Total Program Service Expense43783683TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109629NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees573NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SWEETWATER HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8652138200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1304 CHURCH STREETAddressLine1
CitySWEETWATERCity
StateTNState
ZIP Code37874ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
SCOTT BOWMAN
SECRETARY TREASURER37.50XX219640010863
DR THOMAS EVANS
DIRECTOR1.00X32642300
DOUG WARREN
DIRECTOR1.00X000
RICK BETTIS
DIRECTOR1.00X000
BARBARA WATSON
DIRECTOR1.00X000
PEGGY WHITE
DIRECTOR1.00X000
JON CARSON III
DIRECTOR1.00X000
DR KENYA KOZAWA
DIRECTOR1.00X126901700
DR KEN ARCHER
DIRECTOR1.00X000
JIM FAIRWEATHER
DIRECTOR1.00X000
GARY KIMSEY
DIRECTOR1.00X000
TOM KORN
DIRECTOR1.00X000
CHRIS WHITE
DIRECTOR1.00X000
DEBBIE J THOMPSON
CFO38.00X16532608787
PATTI N THOMPSON
PHARMACIST38.0014307509868X
ROGER EVANS
PHYSICAL THERAPIST38.0010163207551X
ANDREA B HENRY
DIRECTOR OF NURSING38.0013065809237X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2355771TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation46306TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EMERGENCY COVERAGE CORP
PO BOX 634850CINCINNATIOH452634850ER PHYSICIAN SERVICES1560770
KEN KOZAWA I MD PC
132 FAIRLANE CIRCLESWEETWATERTN37874PHYSICIAN SERVICES1269017
CPSI
PO BOX 850309MOBILEAL366850309COMPUTER SUPPORT661910
COUILLARD & ASSOCIATES
9413 WOODY HOLLOW DRIVECHATTANOOGATN37421PHYSICIAN SERVICES557125
H S WHITSON CONSTRUCITON CO
PO BOX 7343KNOXVILLETN37934CONSTRUCTION ARCHITECTS521000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
All Other Contributions2725AllOtherContributions
Total Contributions2725TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code621990BusinessCode
Total Revenue Column56766965TotalRevenueColumn
Related Or Exempt Function Income56766965RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue56766965TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column65753TotalRevenueColumn
Exclusion$65,753ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other3899Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1276Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1276Securities
Other3899Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2623TotalRevenueColumn
Exclusion$2,623ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISCELLANEOUS INCOME900099287958287958
CAFETERIA SALES900099196683196683
MEDICAL RECORDS TRANSCRIPTS9000994331343313
FieldValueIRS element (for citing)
Total Other Revenue527954TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column57366020TotalRevenueColumn
Related Or Exempt Function Income57294919RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$68,376ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total417495Total
Management And General417495ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17104405Total
Program Services15044290ProgramServices
Management And General2060115ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total506091Total
Management And General506091ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total942208Total
Management And General942208ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1254710Total
Program Services1087574ProgramServices
Management And General167136ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8062Total
Management And General8062ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total39350Total
Management And General39350ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2156066Total
Program Services1525364ProgramServices
Management And General630702ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total260667Total
Program Services3247ProgramServices
Management And General257420ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total843723Total
Program Services687829ProgramServices
Management And General155894ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total112309Total
Program Services78111ProgramServices
Management And General34198ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total119915Total
Management And General119915ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3180614Total
Program Services2371200ProgramServices
Management And General809414ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total282709Total
Management And General282709ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT94109029410902
SUPPLIES71247626953047171715
FEES AND REGISTRATIONS6437330641960417726
LAUNDRY132432132432

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total231781Total
Program Services70083ProgramServices
Management And General161698ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total50565531Total
Program Services43783683ProgramServices
Management And General6781848ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3190265BOY
EOY4864126EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY20391658BOY
EOY24441203EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7174296BOY
EOY6989683EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY636271BOY
EOY582807EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY818178BOY
EOY871841EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY111836BOY
EOY119610EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis57272074LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec33532203LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY22412285BOY
EOY23739871EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY997721EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1282859BOY
EOY1405800EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY56017648BOY
EOY64012662EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2969002BOY
EOY4278907EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY444282BOY
EOY332661EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3413284BOY
EOY4611568EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY52604364BOY
EOY59401094EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52604364BOY
EOY59401094EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY56017648BOY
EOY64012662EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6800489ReconcilationRevenueExpenses
Reconcilation Other Changes-3759ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1496323OtherCostOrOtherBasis
Book Value1496323BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20054459OtherCostOrOtherBasis
Depreciation11864763Depreciation
Book Value8189696BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis27774207OtherCostOrOtherBasis
Depreciation21288906Depreciation
Book Value6485301BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7947085OtherCostOrOtherBasis
Depreciation378534Depreciation
Book Value7568551BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23739871TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt57366020TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal57366020RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99057366020TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt50569290TotExpensesEtcAuditedFinclStmt
Other Expenses Included3759OtherExpensesIncluded
Expenses Not Rptd F9903759ExpensesNotRptdF990
Expenses Subtotal50565531ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99050565531TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AS DEFINED IN SECTION 501(C)(3) AND IS EXEMPT FROM FEDERAL TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THAT GUIDANCE, THE ASSOCIATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE THE TAX-EXEMPT STATUS OF THE ASSOCIATION AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES FOR THE FISCAL YEAR 2013 AND 2012. THE ASSOCIATION'S FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, FOR THE YEARS 2010, 2011,2012 AND 2013 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED.
PART XII, LINE 2D - OTHER ADJUSTMENTS:IDEAL RENTAL EXPENSES

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care0FPGReferenceFreeCare
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage100.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent0FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4045743TotalCommunityBenefitExpense
Direct Offsetting Revenue719100DirectOffsettingRevenue
Net Community Benefit Expense3326643NetCommunityBenefitExpense
Percent Of Total Expense0.08080PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense4045743TotalCommunityBenefitExpense
Direct Offsetting Revenue719100DirectOffsettingRevenue
Net Community Benefit Expense3326643NetCommunityBenefitExpense
Percent Of Total Expense0.08080PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense12378TotalCommunityBenefitExpense
Net Community Benefit Expense12378NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense10348TotalCommunityBenefitExpense
Net Community Benefit Expense10348NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense3950TotalCommunityBenefitExpense
Net Community Benefit Expense3950NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense26676TotalCommunityBenefitExpense
Net Community Benefit Expense26676NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4072419TotalCommunityBenefitExpense
Direct Offsetting Revenue719100DirectOffsettingRevenue
Net Community Benefit Expense3353319NetCommunityBenefitExpense
Percent Of Total Expense0.08150PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense10000TotalCommunityBuildingExpense
Net Community Building Expense10000NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense10000TotalCommunityBuildingExpense
Net Community Building Expense10000NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$9,410,902BadDebtExpenseAmount
Amount Attributable To2463063AmountAttributableTo
Amount Reimbursed By Medicare10417216AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare10815836CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-398620MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SWEETWATER HOSPITAL ASSOCIATIONBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1304 WRIGHT STAddressLine1
CitySWEETWATERCity
StateTNState
ZIP Code37874ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SWEETWATER HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed1AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free0UsesFPGFree
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent100.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1SWEETWATER HOSPITAL HOME HEALTHBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1304 WRIGHT STREETAddressLine1
CitySWEETWATERCity
StateTNState
ZIP Code37874ZIPCode
FieldValueIRS element (for citing)
Facility TypeHOME HEALTHFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifier
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 $ 9410902.
PART II: (1)NUTRITION OBESITY: PROVIDED COMMUNITY BASED FITNESS OPPORTUNITIES IN THE SCHOOLS,THROUGH THE CITY PARKS AND HEALTH DEPARTMENT. DONATION OF $10,000 TO THE CITY OF SWEETWATER TO COMPLETE FUNDING FOR COMMUNITY OUTDOOR PART AT THE RECREATIONAL COMPLEX.(2)ACCESS TO HEALTH CARE: PROVIDED HIGH QUALITY CARE IN AN EFFICIENT MANNER TO ALL PATIENTS WHO PRESENT TO THE EMERGENCY DEPARTMENT REGARDLESS OF THE LEVEL OF COMPLAINT OR ABILITY TO PAY.(3)SUBSTANCE ABUSE AND MENTAL HEALTH: SUPPORTED LOCAL NONABUSE MEETINGS, SCHOOL BASED EDUCATION AND POLICE TASK FORCES. COMMUNITY BASED ADULT AND YOUTH EDUCATION AND CRISIS SERVICES WERE PROVIDED. IN COUNTY SERVICES FOR MENTAL HEALTH WERE PROVIDED BY HIAWASSEE MENTAL HEALTH MOBILE CRISIS. COMMUNITY MENTAL HEALTH FORUM TO MEET TO PROVIDE A NETWORKING OPPORTUNITY FOR ALL MENTAL HEALTH PROVIDERS.(4)PREVENTION OF CHRONIC DISEASES: EDUCATION WAS PROVIDER BASED. THE HOSPITAL CONTINUES TO REVIEW IN FUTURE LONG RANGE PLANNING COMMITTEES.HEALTH FAIRS FOR SCHOOLS, HEALTH SCREENING AND DIABETIC TRAINING WERE AMONG SOME OF THE COMMUNITY EVENTS THAT THE HOSPITAL PARTICIPATED IN.
PART III, LINE 4: THE ASSOCIATION ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT WHEN NO PAYMENT IS ANTICIPATED. IN ASSESSING A PATIENT'S ABILITY TO PAY, THE ASSOCIATION USES POVERTY GUIDELINES PUBLISHED BY THE FEDERAL GOVERNMENT FOR MONROE COUNTY. WHEN INCURRED CHARGES ARE SIGNIFICANT COMPARED TO THE PATIENT'S INCOME LEVEL, THE ASSOCIATION MAY CHOOSE TO QUALIFY THE SERVICES AS CHARITY CARE. CHARITY CARE CHARGES ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE.FOOTNOTE IN FINANCIALS:PROVISION FOR BAD DEBTSTHE ASSOCIATION RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY PAYER COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE ASSOCIATION RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY THE POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE ASSOCIATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE ASSOCIATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. BAD DEBT AS A RESULT OF NONPAYMENT OR REDUCED PAYMENT PROVIDES A COMMUNITY BENEFIT TO THOSE WHO ARE UNABLE TO PAY FOR MEDICAL CARE.
PART III, LINE 8: THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE EXCESS OF THE COST OVER REVENUE PROVIDES A BENEFIT TO THOSE IN THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES.
PART III, LINE 9B: FOR PATIENTS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE, IT IS THE POLICY OF SWEETWATER HOSPITAL ASSOCIATION TO PERMIT PATIENTS, WHERE ELIGIBLE TO MAKE REGULAR PAYMENTS ON A MONTHLY BASIS. SWEETWATER HOSPITAL ASSOCIATION DOES UTILIZE EXTERNAL COLLECTION FIRMS FOR DEBT COLLECTION AS NEEDED
PART V, SECTION B, LINE 3: 1. A REVIEW OF EXISTING DATA ALREADY AVAILABLE IN THE COMMUNITY, REGION AND STATE.2. AN IN PERSON SURVEY OF 300 COUNTY RESIDENTS (SURVEYED WHILE AT SWEETWATER HOSPITAL ASSOCIATION INCLUDING PATIENTS, FAMILY AND VISITORS3. A CONVENIENCE SURVEY OF KNOWLEDGEABLE KEY COMMUNITY INFORMANT GROUPS WHICH INCLUDED PHYSICIANS,MONROE COUNTY PRINCIPALS, AND OTHER COMMUNITY LEADERS.SWEETWATER HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 10: THE HOSPITAL DOES NOT PROVIDE FREE CARE.SWEETWATER HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 20D: DISCOUNTED 70% OF GROSS CHARGESSWEETWATER HOSPITAL ASSOCIATION
PART VI, LINE 2: SWEETWATER HOSPITAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITY SERVED BY A REVIEW OF THE EXISTING DATA ALREADY AVAILABLE IN THE COMMUNITY, REGION AND STATE. A SURVEY OF 300 PERSONS WAS CONDUCTED WHILE THEY WERE AT THE HOSPITAL. THIS SURVEY INCLUDED PATIENTS, FAMILY AND VISITORS. A SURVEY WAS ALSO CONDUCTED OF FIFTEEN KNOWLEDGEABLE KEY COMMUNITY INFORMANT GROUPS. KEY INDIVIDUALS WERE ASKED TO RESPOND TO 13 OPEN ENDED QUESTIONS ABOUT THE HEALTH STATUS OF THE COUNTY. THE TOP THREE COMMUNITY HEALTH NEEDS WERE IDENTIFIED AS (1) NUTRITION AND OBESITY (2)AFTER HOURS ACCESS TO CARE (3)SUBSTANCE ABUSE
PART VI, LINE 3: PATIENTS ARE EDUCATED IN THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE POSTING OF POLICY IN THE REGISTRATION OFFICE, POSTING OF THE POLICY ONLINE, AND REQUEST FROM THEIR PATIENT REPRESENTATIVE.
PART VI, LINE 4: MONROE COUNTY IS LOCATED IN THE SOUTHEASTERN PORTION OF THE STATE OF TENNESSEE IN THE FOOTHILLS OF THE SMOKY MOUNTAINS. THE COUNTY HAS A TOTAL AREA OF 653 SQUARE MILES, OF WHICH 635 SQUARE MILES IS LAND AND 18 SQUARE MILES OF IT IS WATER. MONROE COUNTY RANKS AS THE SIXTH LARGEST IN LAND AREA AMOUNG TENNESSEE'S 95 COUNTIES.AS OF THE CENSUS OF 2000 THERE ARE 15,329 HOUSEHOLDS OUT OF WHICH 32.10% HAVE CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM. 59.4% ARE MARRIED COUPLES LIVING TOGETHER. 10% HAVE A FEMALE HOUSEHOLDER WITH NO HUSBAND PRESENT, AND 26.7% ARE NON-FAMILIES. 23.3% OF ALL HOUSEHOLDS ARE MADE UP OF INDIVIDUALS AND 9.4% HAVE SOMEONE LIVING ALONE THAT IS 65 YEARS OF AGE OR OLDER. THE AVERAGE HOUSEHOLD SIZE IS 2.51 AND THE AVERAGE FAMILY SIZE IS 2.94.
PART VI, LINE 5: SWEETWATER HOSPITAL ASSOCIATION IS A 59-BED ACUTE CARE NOT-FOR-PROFIT CORPORATION WHICH WAS CHARTERED BY THE STATE OF TENNESSEE IN 1936. IT IS A UNIQUE ORGANIZATION IN THAT NO STOCK HAS EVER BEEN ISSUED, NOR CAN BE ISSUED IN THE FUTURE. SINCE THERE ARE NEITHER OWNERS NOR STOCKHOLDERS, ANY MONEY GENERATED IN EXCESS OF OPERATIONAL FUNDS IS DEDICATED BY LAW AND RESOLUTION OF THE BOARD OF DIRECTORS TO PERPETUAL USE FOR IMPROVING HEALTH CARE DELIVERY TO THE PEOPLE SERVED BY SWEETWATER HOSPITAL ASSOCIATION.SWEETWATER HOSPITAL ASSOCIATION IS LOCATED IN RURAL EAST TENNESSEE AND PROUDLY SERVES PARTS OF MEIGS COUNTY, MCMINN COUNTY, ROANE COUNTY, LOUDON COUNTY, AND MONROE COUNTY. IT IS THE ONLY HOSPITAL LOCATED IN MONROE COUNTY WHICH HAS A POPULATION OF APPROXIMATELY 38,000.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SCOTT BOWMAN
SECRETARY TREASURER219640000008731021320230503000
DR THOMAS EVANS
DIRECTOR326423000000000326423000
DR KENYA KOZAWA
DIRECTOR12690170000000001269017000
DEBBIE J THOMPSON
CFO165326000006655021320174113000
PATTI N THOMPSON
PHARMACIST143075000005711041570152943000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11MANAGEMENT WILL REVIEW THIS RETURN BEFORE IT IS FILED
FORM 990, PART VI, SECTION B, LINE 12CPOSSIBLE CONFLICT OF INTEREST ARE REQUIRED TO BE DISCLOSED ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15TOP OFFICIALS ARE APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION FOR OFFICERS USE INDUSTRY STANDARDS, AND COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST
FORM 990, PART VIIDR. KENYA KOZAWA - 132 FAIRLANE CIRCLE, SWEETWATER, TN 37874.CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
DR. KOWAZA OFFICER COMPENSATION PART VII SECTION BCOMPENSATION FOR DR. KOWAZA WAS FOR THE PHYSICIANS SERVICES RENDERED BY HIS P.C.
FORM 990, PART XI, LINE 9:SUBSIDIARY EXPENSES -3,759.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1IDEAL RENTAL COMPANY INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1304 WRIGHT STAddressLine1
CitySWEETWATERCity
StateTNState
ZIP Code37874ZIPCode
FieldValueIRS element (for citing)
EIN620933728EIN
Primary ActivityREAL ESTATEPrimaryActivity
Legal Domicile StateTNLegalDomicileState
Type Of EntityCTypeOfEntity
Share Of Total Income-3759ShareOfTotalIncome
Share Of EOY Assets-33047ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg