CULLMAN REGIONAL MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CULLMAN REGIONAL MEDICAL CENTER INC (EIN 63-1058174)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-02-27
- IRS object ID
- 201440589349300504
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-02-27T08:50:30-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 317081309 | 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 | 631058174 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULLMAN REGIONAL MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CULL | NameControl |
| Phone | 2567372598 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1 |
| City | CULLMAN | City |
| State | AL | State |
| ZIP Code | 35058 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | NESHA DONALDSON | Name |
| Title | CFO | Title |
| Phone | 2567372598 | Phone |
| Date Signed | 2014-05-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JACQUELINE G ATKINS | Name |
| Phone | 2298837878 | Phone |
| Date Prepared | 2014-02-26 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JIM WEIDNER CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1 |
| City | CULLMAN | City |
| State | AL | State |
| ZIP Code | 35058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 95060045 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | CRMCHOSPITAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1939 | YearFormation |
| State Legal Domicile | AL | StateLegalDomicile |
| Activity Or Mission Description | CULLMAN REGIONAL MEDICAL CENTER, LICENSED FOR 145 BEDS, OPERATES A 115-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF CULLMAN, ALABAMA AND SURROUNDING AREAS REGARDLESS OF A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1159 | TotalNbrEmployees |
| Total Nbr Volunteers | 58 | TotalNbrVolunteers |
| Total Gross UBI | 1180603 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 65152 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 899159 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 714318 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 86348609 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 88112173 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1430535 | InvestmentIncomePriorYear |
| Investment Income Current Year | 347428 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5599750 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5063637 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 94278053 | TotalRevenuePriorYear |
| Total Revenue Current Year | 94237556 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 75004 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 74177 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 47975187 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 45592056 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 48051373 | OtherExpensePriorYear |
| Other Expenses Current Year | 47868267 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 96101564 | TotalExpensesPriorYear |
| Total Expenses Current Year | 93534500 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1823511 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 703056 | RevenuesLessExpensesCY |
| Total Assets BOY | 98326482 | TotalAssetsBOY |
| Total Assets EOY | 100396208 | TotalAssetsEOY |
| Total Liabilities BOY | 97809827 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 86250051 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 516655 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14146157 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CULLMAN REGIONAL MEDICAL CENTER, LICENSED FOR 145 BEDS, OPERATES A 115-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF CULLMAN, ALABAMA AND SURROUNDING AREAS REGARDLESS OF A PATIENT'S ABILITY TO PAY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 80978351 | Expense |
| Grants | 74177 | Grants |
| Revenue | 90975919 | Revenue |
| Description | CRMC PROVIDES ACUTE CARE PATIENT SERVICES WHICH ARE RENDERED TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. CRMC USES CHARITY APPLICATIONS BASED UPON FEDERAL POVERTY GUIDELINES AND FAMILY SIZE TO DETERMINE ELIGIBILITY FOLLOWING SERVICES PROVIDED. CRMC PROVIDES CARE 24 HOURS PER DAY, SEVEN DAYS A WEEK AND HAS PROVIDED 23,325 INPATIENT DAYS CARE, 6% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; 44,961 EMERGENCY ROOM VISITS, 21% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; AND 91,950 OUTPATIENT VISITS, 5% NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN. THE TOTAL UNREIMBUSED COST OF MEDICAL SERVICES PROVIDED TO THOSE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN IS REPORTED ON SCHEDULE H. CRMC ALSO PROVIDES COMMUNITY EDUCATION AND WELLNESS ACTIVITIES TO THE COMMUNITY AND IS A MAJOR CONTRIBUTOR TO A LOCAL INDIGENT CLINIC SERVICING CULLMAN COUNTY. | Description |
| Total Program Service Expense | 80978351 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 207 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 1159 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | NESHA DONALDSON | NamePerson |
| Telephone Number | 2567372598 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HWY 157 | AddressLine1 |
| City | CULLMAN | City |
| State | AL | State |
| ZIP Code | 35058 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| JIM WEIDNER | |||||||||
| CEO | 40.00 | 1.00 | X | X | 289952 | 0 | 18174 | ||
| DAVID MCKOY | |||||||||
| PAST CHAIRMA | 2.00 | X | 0 | 0 | 0 | ||||
| TODD MCLEROY | |||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | |||
| HOYT BROWNIE PRICE MD | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| ALAN WOOD | |||||||||
| VICE CHAIRMA | 2.00 | X | X | 0 | 0 | 0 | |||
| R CLYNE ADAMS DMD | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| CLINT FREY | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| DEL BROCK | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| ROBIN HALL MD | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| STEPHEN DONALDSON | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| JUDY BUTLER | |||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | |||
| ROGER HUMPHREY | |||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | |||
| VINCE BERGQUIST MD | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| GREG BARKSDALE | |||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||||
| CHERYL BAILEY | |||||||||
| CNO | 40.00 | X | 130956 | 0 | 3811 | ||||
| NESHA DONALDSON | |||||||||
| CFO | 40.00 | 1.00 | X | 109523 | 0 | 3202 | |||
| SUSAN JOHNSON | |||||||||
| FORMER HOSPI | 40.00 | 121875 | 0 | 727 | X | ||||
| SUSAN COPELAND | |||||||||
| VP-AMB. | 40.00 | 114180 | 0 | 7481 | X | ||||
| STACEY HILL | |||||||||
| PHARMACY DIR | 40.00 | 113063 | 0 | 13498 | X | ||||
| JERIMAH DAVIS | |||||||||
| DIV DIRECTOR | 40.00 | 111526 | 0 | 12501 | X | ||||
| TERESA AARON | |||||||||
| PHARMACIST | 40.00 | 110851 | 0 | 12413 | X | ||||
| JETE EDMISSON | |||||||||
| FORMER CFO | 0.00 | 0.00 | 104996 | 0 | 5792 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1206922 | TotalReportableCompFromOrg |
| Total Other Compensation | 77599 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CULLMAN ANESTHESIOLOGY & PAIN CONSUL | |||||
| PO BOX 1005 | CULLMAN | AL | 350561005 | CRNA SVCS | 1824921 |
| MEDASSETS | |||||
| P O BOX 405652 | ATLANTA | GA | 303845652 | BUS OFC SVCS | 1629114 |
| CROTHALL HEALTHCARE INC | |||||
| 13028 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ENVIRONMENTAL S | 671554 |
| HUNTSVILLE HOSPITAL | |||||
| 109 GOVERNORS DRIVE SW | HUNTSVILLE | AL | 35801 | BUS OFC SVCS | 467789 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| P O BOX 636981 | CINCINNATI | OH | 452636981 | WOUND CARE SVC | 445497 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 27 | NumberOfContractorsGT100K |
| Related Organizations | 377566 | RelatedOrganizations |
| Government Grants | 248674 | GovernmentGrants |
| All Other Contributions | 88078 | AllOtherContributions |
| Total Contributions | 714318 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT SERVICE REVENUES | 623000 | 86931570 | 86931570 | |
| OUTREACH LAB SERVICES | 621500 | 670784 | 670784 | |
| CPAP MEDICAL EQUIPMENT | 621990 | 433388 | 433388 | |
| CONFERENCE CENTER | 532000 | 47063 | 47063 | |
| SPORTS FIRST | 713940 | 29368 | 29368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 88112173 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1036290 | TotalRevenueColumn |
| Exclusion | $1,036,290 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 227445 | Real |
| Personal | 411356 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 227445 | Real |
| Personal | 411356 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 638801 | TotalRevenueColumn |
| Related Or Exempt Function Income | 411356 | RelatedOrExemptFunctionIncome |
| Exclusion | $227,445 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 133627 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 822489 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -688862 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -688862 | TotalRevenueColumn |
| Exclusion | -$688,862 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EMS MANAGEMENT FEES | 621910 | 2752076 | 2752076 | |
| CAFETERIA/CATERING | 561000 | 572473 | $572,473 | |
| COMMUNITY SERVICE/EDUCATION | 713940 | 431346 | 431346 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 668941 | TotalRevenueColumn |
| Related Or Exempt Function Income | 449571 | RelatedOrExemptFunctionIncome |
| Exclusion | $219,370 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4424836 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 94237556 | TotalRevenueColumn |
| Related Or Exempt Function Income | 90975919 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1180603 | UnrelatedBusinessRevenue |
| Exclusion | $1,366,716 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74177 | Total |
| Program Services | 74177 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 555618 | Total |
| Management And General | 555618 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110788 | Total |
| Management And General | 110788 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34709293 | Total |
| Program Services | 31454182 | ProgramServices |
| Management And General | 3255111 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1658811 | Total |
| Program Services | 1490292 | ProgramServices |
| Management And General | 168519 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5897496 | Total |
| Program Services | 5261633 | ProgramServices |
| Management And General | 635863 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2660050 | Total |
| Program Services | 2367178 | ProgramServices |
| Management And General | 292872 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2659782 | Total |
| Program Services | 2210501 | ProgramServices |
| Management And General | 449281 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 612540 | Total |
| Program Services | 47706 | ProgramServices |
| Management And General | 564834 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148476 | Total |
| Management And General | 148476 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113277 | Total |
| Management And General | 113277 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9851166 | Total |
| Program Services | 8145560 | ProgramServices |
| Management And General | 1705606 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160199 | Total |
| Program Services | 890 | ProgramServices |
| Management And General | 159309 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10835592 | Total |
| Program Services | 9147365 | ProgramServices |
| Management And General | 1688227 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68829 | Total |
| Management And General | 68829 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6543641 | Total |
| Program Services | 6194211 | ProgramServices |
| Management And General | 349430 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 434575 | Total |
| Program Services | 417352 | ProgramServices |
| Management And General | 17223 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35880 | Total |
| Program Services | 12665 | ProgramServices |
| Management And General | 23215 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1876 | Total |
| Management And General | 1876 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4602300 | Total |
| Program Services | 4356537 | ProgramServices |
| Management And General | 245763 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 641818 | Total |
| Program Services | 641818 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 8765472 | 8765472 | |
| REPAIRS AND MAINT | 2099936 | 385323 | 1714613 |
| DUES AND SUBSCRIPTIONS | 122343 | 122343 | |
| TAXES AND LICENSE | 107077 | 107077 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63488 | Total |
| Program Services | 5489 | ProgramServices |
| Management And General | 57999 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93534500 | Total |
| Program Services | 80978351 | ProgramServices |
| Management And General | 12556149 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3877620 | BOY |
| EOY | 7504453 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13849345 | BOY |
| EOY | 10581800 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 390565 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 928471 | BOY |
| EOY | 1059085 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 626132 | BOY |
| EOY | 618992 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 103768290 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 67303122 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37488871 | BOY |
| EOY | 36465168 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34195337 | BOY |
| EOY | 37526323 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2207757 | BOY |
| EOY | 3060521 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5152949 | BOY |
| EOY | 3189301 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98326482 | BOY |
| EOY | 100396208 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10628658 | BOY |
| EOY | 11222854 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25950 | BOY |
| EOY | 36128 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68167633 | BOY |
| EOY | 66479971 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233184 | BOY |
| EOY | 255754 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18754402 | BOY |
| EOY | 8255344 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97809827 | BOY |
| EOY | 86250051 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 516655 | BOY |
| EOY | 14146157 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 516655 | BOY |
| EOY | 14146157 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98326482 | BOY |
| EOY | 100396208 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 703056 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1971570 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 10954876 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | 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 | 1819363 | OtherCostOrOtherBasis |
| Book Value | 1819363 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44289832 | OtherCostOrOtherBasis |
| Depreciation | 20807062 | Depreciation |
| Book Value | 23482770 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7036443 | OtherCostOrOtherBasis |
| Depreciation | 5927306 | Depreciation |
| Book Value | 1109137 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 49437433 | OtherCostOrOtherBasis |
| Depreciation | 40568754 | Depreciation |
| Book Value | 8868679 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1185219 | OtherCostOrOtherBasis |
| Book Value | 1185219 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 36465168 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| MINIMUM PENSION LIABILITY | $5,642,894 |
| ACCRUED INTEREST | $1,785,888 |
| INTERCOMPANY LIABILITY | $826,562 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8255344 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LIABILITY UNDER FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PAGE 3, PART X | ReturnReference |
| Explanation | THE AUTHORITY IS A TAX-EXEMPT ENTITY; THEREFORE, NO PROVISION FOR INCOME TAXES IS MADE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2013 AND 2012 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2010-2012. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1604 | PersonsServed |
| Total Community Benefit Expense | 1772388 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1772388 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01890 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17749 | PersonsServed |
| Total Community Benefit Expense | 8512884 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4375302 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4137582 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04420 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 19353 | PersonsServed |
| Total Community Benefit Expense | 10285272 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4375302 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5909970 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06320 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 5113 | PersonsServed |
| Total Community Benefit Expense | 484204 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3840 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 480364 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00510 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 304 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 304 | NetCommunityBenefitExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 13560 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13560 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 29 | NumberOfActivitiesOrPrograms |
| Persons Served | 5113 | PersonsServed |
| Total Community Benefit Expense | 498068 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3840 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 494228 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00530 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 29 | NumberOfActivitiesOrPrograms |
| Persons Served | 24466 | PersonsServed |
| Total Community Benefit Expense | 10783340 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4379142 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6404198 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06850 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 56 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 56 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 26160 | PersonsServed |
| Total Community Building Expense | 28132 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1610 | DirectOffsettingRevenue |
| Net Community Building Expense | 26522 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 16 | NumberOfActivitiesOrPrograms |
| Persons Served | 26160 | PersonsServed |
| Total Community Building Expense | 28188 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1610 | DirectOffsettingRevenue |
| Net Community Building Expense | 26578 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $24,871,805 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 35566731 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 35960446 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -393715 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERITAGE DIAGNOSTICS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | IMAGING SERVICES | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.21000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.79000 | PhysicansProfitOrOwnership |
| 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 | CULLMAN REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1 |
| City | CULLMAN | City |
| State | AL | State |
| ZIP Code | 35058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP//CRMCHOSPITALCOM | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | HOSPICE, CLINICS & HOME HEALTH | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULLMAN REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | 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 |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 150.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF CULLMAN COUNTY | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1912 ALABAMA HIGHWAY 157 | AddressLine1 |
| City | CULLMAN | City |
| State | AL | State |
| ZIP Code | 35058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | HOSPICE | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE | PART I LINE 3C | FEDERAL POVERTY GUIDELINES 150 ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE DISCOUNTED CARE WILL BE BASED ON MEDICARE REIMBURSEMENT |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATIONS A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS 2008 SEE ALSO THE DESCRIPTION FOR PART III LINE 4 |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | LINE 2 IS TAKEN DIRECTLY FROM THE INCOME STATEMENT AND REPRESENTS TOTAL BAD DEBT EXPENSED DURING THE FISCAL YEAR THE FOLLOWING IS AN EXCERPT FROM THE AUDITED FINANCIAL STATEMENTS THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE |
| MEDICARE EXPLANATION | PART III LINE 8 | THE HOSPITAL UTILIZES LYONS SOFTWARE FOR COST ACCOUNTING PURPOSES THE MEDICARE COST REPORT WAS USED TO GATHER INFORMATION RELATED TO MEDICARE CHARGES AND REIMBURSEMENT MEDICARE COST WAS CALCULATED BY ADDING DIRECT COSTS TO INDIRECT COSTS WHICH ARE ALLOCATIONS OF OVERHEAD DEPARTMENTS USING A REASONABLE STATISTICAL BASIS |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL AID POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL AID THEY ARE NOT REPORTED AS REVENUE |
| NEEDS ASSESSMENT | PART VI | THE HOSPITAL PARTICIPATES IN THE CULLMAN COUNTY HEALTH COALITION THIS ORGANIZATION COMPRISED OF VARIOUS HEALTH CARE PROVIDERS AND COMMUNITY LEADERS ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY AND STRIVES TO PROVIDE RESOURCES THAT BEST MEET THOSE NEEDS CRMC FILED A COMMUNITY HEALTH NEEDS ASSESSMENT AND IT IS AVAILIABLE ON THE HOSPITAL WEBSITE |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL AID POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGHOUT THE BUSINESS OFFICE SIGNS ARE PROMINENTLY POSTED IN THE ER ABOUT THE AVAILABILITY OF FINANCIAL AID A REPRESENTATIVE IS ALSO AVAILABLE TO DISCUSS ELIGIBILITY TO GOVERNMENT PROGRAMS THERE IS ALSO A MEDICAID KIOSK LOCATED IN THE ER WAITING ROOM |
| COMMUNITY INFORMATION | PART VI | THE HOSPITAL DRAWS PATIENTS PRINCIPALLY FROM CULLMAN COUNTY AND THE NEIGHBORING COUNTIES OF WALKER WINSTON MARSHALL MORGAN AND BLOUNT CRMC IS THE ONLY HOSPITAL IN ITS PRIMARY SERVICE AREA THE PRIMARY SERVICE AREA INCLUDES THE CITY OF CULLMAN POPULATION 15000 AND CULLMAN COUNTY POPULATION 81000 PER CAPITA INCOME FOR THIS AREA IS SLIGHTLY BELOW THE PER CAPITA INCOME FOR THE STATE OF ALABAMA CULLMAN IS SERVED BY I65 AND IS LOCATED BETWEEN HUNTSVILLE AND BIRMINGHAM |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | THE ORGANIZATION AND ITS VOLUNTEER BOARDS ARE COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS AS WELL AS PHYSICIAN MEMBERS THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY 7 DAYS PER WEEK AND IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY HOSPITAL EMPLOYEES IN CONJUNCTION WITH OUR LOCAL JUDGES HAVE DEVELOPED A TRAUMA PREVENTION PROGRAM THIS PROGRAM IS PROVIDED BY CRMC EMPLOYEES ON A VOLUNTARY BASIS OUR LOCAL JUDGES REFER TEENAGE DRIVING OFFENDERS TO THE PROGRAM TO TEACH THEM THE IMPORTANCE OF VEHICLE SAFETY WHILE THEY ARE HERE THEY ACTUALLY GET TO WITNESS THE VARIOUS STAGES OF A TRAUMA ACCIDENT FROM THE TIME THEY ARRIVE AT THE ER UNTIL THEY LEAVE THE HOSPITAL COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE PROVIDING AMBULANCE SUPPORT FOR VARIOUS COMMUNITY ACTIVITIES AND PROVIDING COMMUNITY SUPPORT GROUPS THESE SUPPORT GROUPS ALZHEIMERS BREAST CANCER ETC PROMOTE THE PHYSICAL AND MENTAL HEALTH OF THE COMMUNITY THAT WE SERVE CRMC PROVIDES WOMENS FIRST AND SENIOR CHOICE PROGRAMS THE WOMENS FIRST PROGRAM OFFERS SEMINARS AND EDUCATION ON HEALTH AND LIFESTYLE ISSUES SUCH AS STRESS MANAGEMENT PMS MENOPAUSE AND HEART DISEASE IT ALSO GIVES DISCOUNT ADMISSION TO WORKSHOPS AND HEALTH SCREENINGS SENIOR CHOICE PROVIDES SERVICES TO PROMOTE EMOTIONAL SOCIAL AND PHYSICAL WELL BEING FOR COMMUNITY MEMBERS WHO ARE 50 AND OVER THESE PROGRAMS CURRENTLY HAVE 6974 MEMBERS CRMC ALSO PROVIDES A COMMUNITY EDUCATION CENTER WHICH OFFERS MEETING ROOMS AND CATERING SERVICES FOR LOCAL BUSINESSES CHURCHES CIVIC ORGANIZATIONS AND EDUCATIONAL GROUPS ALL OF OUR AMBULANCES ARE EQUIPPED WITH 12 LEAD EKG TECHNOLOGY WHICH TRANSMITS THE INFORMATION DIRECTLY TO THE EMERGENCY ROOM PHYSICIAN ALLOWING THEM TO GET THE INFORMATION WHILE THE PATIENT IS IN TRANSIT THIS PROGRAM HAS REDUCED THE TIME FROM DOOR TO ANGIOPLASTY BY GETTING THE CARDIOLOGY TEAM IN PLACE BEFORE THE PATIENT ARRIVES |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | ALABAMA |
| CULLMAN REGIONAL MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | THE CULLMAN COUNTY COMMUNITY HEALTH COALITION CREATED A TARGETED LIST OF AREAS OF EXPERTISE IN THE COMMUNITY THAT WOULD PROVIDE VALUABLE INPUT EACH MEMBER OF THE COALITION WAS RESPONSIBLE FOR SUPPLYING AND COLLECTING SURVEYS TO THESE DIFFERENT AREAS IN THE COMMUNITY THESE AREAS WOULD HELP GENERATE INPUT FROM A VARIETY OF SOURCES THAT WOULD HELP GENERATE AN OVERALL VIEW OF THE HEALTH OF THE COMMUNITY THE GROUP ALSO CREATED BOTH A PRINTED SURVEY AND AN ONLINE ELECTRONIC SURVEY IN ORDER TO REACH MULTIPLE DEMOGRAPHICS THROUGHOUT THE COMMUNITY AFTER BOTH THE SURVEY DATA AND SECONDARY DATA WERE COMPILED DISCUSSION WAS CONDUCTED BY THE MEMBERS OF THE CULLMAN COUNTY COMMUNITY HEALTH COALITION IN ORDER TO COLLECT PRIMARY DATA ABOUT OUR COMMUNITY THE COMMUNITY HEALTH COALITION MEMBERS REPRESENT BOTH THE HEALTHCARE COMMUNITY AND THE COMMUNITY AT LARGE THEREFORE THIS GROUP SERVED AS THE FOCUS GROUP PORTION OF THE NEEDS ASSESSMENT PROCESS ONCE DATA COLLECTION WAS COMPLETE A DISCUSSION MEETING WAS HELD WITH SEVERAL KEY COALITION AND COMMUNITY MEMBERS TO DISCUSS THE FINDINGS AND OBTAIN THEIR ASSISTANCE IN SETTING PRIORITIES TO RESPOND TO NEEDS IN THE COMMUNITY FINALLY A LEADERSHIP COMMITTEE WITHIN CULLMAN REGIONAL MEDICAL CENTER MET TO PRIORITIZE THESE NEEDS EVEN FURTHER AND DETERMINE HOW CULLMAN REGIONAL CAN BEST PARTICIPATE IN HELPING TO MEET THE NEEDS OF THE COMMUNITY |
| CULLMAN REGIONAL MEDICAL CENTER LINE NUMBER 1 PART V LINE 12H | PART V LINE 12H | THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL AID POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGH THE BUSINESS OFFICE SIGNS ARE PROMINENTLY POSTED IN THE ER ABOUT THE AVAILABILITY OF FINANCIAL AID A REPRESENTATIVE IS ALSO AVAILABLE TO DISCUSS ELIGIBILITY TO GOVERNMENT PROGRAMS |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN CLINIC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 ARNOLD ST NE | AddressLine1 |
| City | CULLMAN | City |
| State | AL | State |
| ZIP Code | 35055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 200149215 | EINOfRecipient |
| IRC Section | 3 | IRCSection |
| Amount Of Cash Grant | 74177 | AmountOfCashGrant |
| Purpose Of Grant | CURRENT OPERATIONS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | ReturnReference |
| Explanation | THE HOSPITAL CONTINUOUSLY EVALUATES COMMUNITY ORGANIZATIONS (AS IDENTIFIED IN PART II ABOVE) PROVIDING HEALTHCARE NEEDS TO THE MEDICALLY UNDERSERVED WHO ALSO ARE MOST LIKELY UNABLE TO PAY. THE HOSPITAL EVALUATES THE NEEDS ON AN INDIVIDUAL BASIS BASED ON DOCUMENTED REQEUSTS FOR SERVICES PROVIDED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|
| JIM WEIDNER | |||||
| CEO | 289281 | 671 | 8337 | 9837 | 308126 |
| JETE EDMISSON | |||||
| FORMER CFO | 104785 | 211 | 5792 | 110788 | |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | SUSAN JOHNSON 40,830 0 0 JETE EDMISSON 104,785 0 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | JETE EDMISSION RECEIVED A SEVERANCE PACKAGE UPON TERMINATION IN ACCORDANCE WITH HIS CONTRACTUAL AGREEMENT. |
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 CARE AUTHORITY OF CULLMAN CT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 631149220 | IssuerEIN |
| CUSIP Number | 230186AMO | CUSIPNumber |
| Date Issued | 2009-12-03 | DateIssued |
| Issue Price | 68624416 | IssuePrice |
| Description Of Purpose | DEFEASE 1993/2007 BONDS. | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 3323953 | AmountRetired |
| Total Proceeds | 68624416 | TotalProceeds |
| Refunding Escrow | 61819381 | RefundingEscrow |
| Issuance Costs From Proceeds | 1352854 | IssuanceCostsFromProceeds |
| Working Capital Expenditures | 5452182 | WorkingCapitalExpenditures |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | false | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | true | ChangeInUseBondFinancedProp |
| Prcntge Bond Financed Prop | 0.01100 | PrcntgeBondFinancedProp |
| Remedial Action Taken | true | RemedialActionTaken |
| Non Qualified Bond Remed Procdrs | false | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiled |
| Rebate Not Due Yet | true | RebateNotDueYet |
| Exception To Rebate | false | ExceptionToRebate |
| No Rebate Due | false | NoRebateDue |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | true | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERRILL LYNCH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 26.0 | TermOfHedge |
| Superintegrated Hedge | false | SuperintegratedHedge |
| Hedge Terminated | false | HedgeTerminated |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | false | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE K | ReturnReference |
| Explanation | HEALTH CARE AUTHORITY OF CULLMAN CT THE ONLY BONDS ISSUED BY THE AUTHORITY FOR THE BENEFIT OF CRMC ARE THE 2009 BONDS WHICH WERE ISSUED DECEMBER 3 2009 A PORTION OF THE BONDS IS ALLOCABLE TO CAPITAL EQUIPMENT THE BOND FINANCED EQUIPMENTFINANCED BY CRMC AND THE AUTHORITY FOR USE AT A FREE STANDING RADIATION ONCOLOGY CENTER OPERATED BY CRMC THE BONDFINANCED EQUIPMENT WAS SOLD ON DECEMBER 31 2010 FOR CASH IN THE AMOUNT OF 800000 TO A NONGOVERNMENTAL PERSON THE SALE CONSTITUTES A DISPOSITION OF THE BONDFINANCED EQUIPMENT FOR PURPOSES OF THE CHANGE IN USE RULES WITHIN 2 YEARS OF THE SALE DATE THE AUTHORITY COMPLIED WITH THE REQUIREMENTS OF TREASURY REGULATION 114112E AND USED THE DISPOSITION PROCEEDS FOR ALTERNATE USES | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FIRST ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | COMMUNITY EDUCATION AND WELLNESS ACTIVITIES TO THE COMMUNITY AND IS A MAJOR CONTRIBUTOR TO A LOCAL INDIGENT CLINIC SERVICING CULLMAN COUNTY. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY IS THE SOLE MEMBER OF CULLMAN REGIONAL MEDICAL CENTER INC. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS AS WELL. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS OF THE ORGANIZATION. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | MANAGEMENT ASSISTS IN PREPARING SCHEDULES, REVIEWS THE ENTIRE DRAFT OF THE FORM 990 FOR CONTENT, AND RECOMMENDS CHANGES, IF ANY. PRIOR TO FILING, THE FINANCE COMMITTEE, CFO, ATTORNEY AND ACCOUNTING DEPARTMENT REVIEW THE FORM. THE FINAL FORM, AS IT IS ULTIMATELY FILED WITH ALL SCHEDULES AND ATTACHMENTS, IS POSTED TO THE BOARD WEBSITE PRIOR TO FILING AND AN E-MAIL ALERTS EACH VOTING MEMBER OF ITS AVAILABILITY. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY, BOARD MEMBERS, OFFICERS, AND DEPARTMENTAL DIRECTORS MUST IDENTIFY ANY CONFLICT, MANAGEMENT MONITORS AND MAY SUGGEST ANY AREAS OF CONFLICT. THE BOARD CHAIRMAN OR ADMINISTRATION REVIEWS ACTUAL AND PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT OF A CONFLICT, THE MEMBER OR OFFICER WITH THE CONFLICT WILL DISMISS THEMSELVES FROM THE DISCUSSION AND ANY VOTES ON THE ISSUE. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | ANNUALLY THE BOARD (OR A COMMITTEE CHARGED WITH THE RESPONSIBILITY AND AUTHORITY TO DO SO ON BEHALF OF THE BOARD) REVIEWS THE COMPENSATION PACKAGE AND PROPOSED CONTRACT OF THE CEO. THE REVIEW IS CONDUCTED BY INDEPENDENT BOARD MEMBERS, IS BASED UPON REVIEW OF COMPARABILITY DATA PROVIDED BY OUTSIDE CONSULTANTS, AND IS DOCUMENTED IN THE RECORDS OF THE BOARD REFLECTING THE BASIS OF THE DETERMINATION BY THE THE BOARD (OR AUTHORIZED COMMITTEE). |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | ANNUALLY THE CEO REVIEWS THE COMPENSATION PACKAGE OF THE CFO AND OTHER OFFICERS. THE REVIEW UTILIZES A SALARY SCALE AND MATRIX ESTABLISHED BY CRMC'S HUMAN RESOURCE DEPARTMENT AND CONSIDERS THE ACCOMPLISHMENT OF KEY PERSONAL AND ORGANIZATIONAL GOALS. COMPENSATION IS BASED ON YEARS OF EXPERIENCE IN THAT POSITION AND USES GUIDELINES FOR INHOUSE PROMOTIONS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | CONTRACT LABOR 11,806 44,660 0 MEDICAL PROFESSIONAL FEE 1,197,951 160,207 0 OUTSIDE SERVICE FEES 6,439,699 1,500,739 0 COLLECTION FEES 406,868 0 0 RECRUITING FEES 89,236 0 0 |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | CHANGE IN VALUE OF INTEREST RATE SWAP 439,224 CHANGE IN PLAN ASSETS & PBO 9,662,888 CHANGE IN TEMP REST NET ASSETS OF AFFILIATE 941,212 CHANGE IN UNRESTRICTED ASSETS OF AFFILIATE -88,448 NET INCREASE IN NET ASSETS 10,954,876 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| CULLMAN REGIONAL MEDICAL CTR FNDN | ||||||||||
| 1912 ALABAMA HIGHWAY 157 | CULLMAN | AL | 35056 | 630727880 | FOUNDATION | AL | 501C3 | 11C | NA | false |
| HEALTH CARE AUTHORITY OF CULLMAN CO | ||||||||||
| 1912 ALABAMA HIGHWAY 157 | CULLMAN | AL | 35058 | 631149220 | AUTHORITY | AL | 501C1 | 6 | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |