CITIZENS MEMORIAL HEALTH CARE FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CITIZENS MEMORIAL HEALTH CARE FOUNDATION (EIN 43-1425356)
- Tax period
- 2011-06-01 to 2012-05-31
- Filed
- 2013-03-05
- IRS object ID
- 201300649349300510
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-03-05T11:38:47-06:00 | Timestamp |
| Tax Period End Date | 2012-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431425356 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITIZENS MEMORIAL HEALTH CARE FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % RENEE MEYER | InCareOfName |
| Name Control | CITI | NameControl |
| Phone | 4173266000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1 |
| City | BOLIVAR | City |
| State | MO | State |
| ZIP Code | 65613 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DONALD J BABB | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Date Signed | 2013-01-28 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brian D Todd | Name |
| Phone | 4178658701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DONALD J BABB | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1 |
| City | BOLIVAR | City |
| State | MO | State |
| ZIP Code | 65613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 39933814 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.citizensmemorial.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | THE ORGANIZATION CARES FOR EVERY GENERATION THROUGH EXCEPTIONAL SERVICES BY LEADING PHYSICIANS AND A COMPASSIONATE HEALTHCARE TEAM. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 942 | TotalNbrEmployees |
| Total Nbr Volunteers | 76 | TotalNbrVolunteers |
| Total Gross UBI | 6719 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 1511 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 303900 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3734023 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 30715253 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 33329516 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 163981 | InvestmentIncomePriorYear |
| Investment Income Current Year | 352688 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -241958 | OtherRevenuePriorYear |
| Other Revenue Current Year | -269101 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 30941176 | TotalRevenuePriorYear |
| Total Revenue Current Year | 37147126 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 81642 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 80200 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 17512367 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19704957 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 12321956 | OtherExpensePriorYear |
| Other Expenses Current Year | 13565626 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 29915965 | TotalExpensesPriorYear |
| Total Expenses Current Year | 33350783 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1025211 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3796343 | RevenuesLessExpensesCY |
| Total Assets BOY | 46811823 | TotalAssetsBOY |
| Total Assets EOY | 48795367 | TotalAssetsEOY |
| Total Liabilities BOY | 37527235 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 35824253 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9284588 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12971114 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO SUPPORT AND ASSIST CITIZENS MEMORIAL HOSPITAL DISTRICT, OR ITS SUCCESSORS, OR ANY HEALTH CARE INSTITUTION WITH WHICH IT MAY MERGE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | true | SignificantChange |
| Expense | 20130476 | Expense |
| Revenue | 27559731 | Revenue |
| Description | PROVIDE LONG TERM CARE SERVICES TO MEDICAID RECIPIENTS (APPROXIMATELY 165,719 RESIDENT DAYS) IN SKILLED FACILITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1033979 | Expense |
| Revenue | 1375829 | Revenue |
| Description | PROVIDE RESIDENTIAL CARE SERVICES FOR THE ELDERLY TO APPROXIMATELY 26,055 RESIDENT DAYS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 485892 | Expense |
| Revenue | 615563 | Revenue |
| Description | PROVIDE HOME CHORE SERVICES TO PEOPLE LIVING AT HOME BUT UNABLE TO COMPLETELY CARE FOR THEMSELVES. THROUGH HOMEMAKER PLUS, 34,617 SERVICE UNITS WERE PROVIDED THROUGH LIGHT HOUSEKEEPING, LAUNDRY, SHOPPING AND RESPITE CARE SERVICES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 4536844 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 80200 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 3809709 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 26187191 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | true | 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 | false | 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 | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | 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 | true | 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 | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 78 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 942 | 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 | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| 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 | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | false | CompensationProcessCEO |
| Compensation Process Other | false | 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 | RENEE MEYER | NamePerson |
| Telephone Number | 4173286258 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1 |
| City | BOLIVAR | City |
| State | MO | State |
| ZIP Code | 65613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DONALD J BABB | |||||||
| EXECUTIVE DIRECTOR | 20.0 | X | X | 109672 | 313827 | 43606 | |
| DAVE STRADER | |||||||
| BOARD PRESIDENT | 1.0 | X | X | 0 | 0 | 0 | |
| BRAD GREGORY | |||||||
| BOARD VICE PRESIDENT | 1.0 | X | X | 0 | 0 | 0 | |
| ROBERT KIFER | |||||||
| BOARD MEMBER ENDING 12/2011 | 1.0 | X | 0 | 0 | 0 | ||
| DAVE BERRY | |||||||
| BOARD MEMBER ENDING 3/2012 | 1.0 | X | 0 | 0 | 0 | ||
| DEREK HUNTER | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| D MICHEALE MEENTS | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| NEALE JOHNSON | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| RUSSEL PAYNE | |||||||
| BOARD MEMBER BEGINNING 2/2012 | 1.0 | X | 0 | 0 | 0 | ||
| WILLIAM DONNELL | |||||||
| BOARD MEMBER BEGINNING 03/2012 | 1.0 | X | 0 | 0 | 0 | ||
| GARY FULBRIGHT | |||||||
| BOARD TREASURER - NONVOTING | 45.0 | X | 0 | 224430 | 33724 | ||
| CATHERINE MOLDER | |||||||
| BOARD SECRETARY - NONVOTING | 45.0 | X | 0 | 89196 | 8293 | ||
| RENEE MEYER | |||||||
| DIRECTOR OF FINANCE | 45.0 | X | 136088 | 0 | 10038 | ||
| KENNETH SCHANDA | |||||||
| DIRECTOR OF REHAB SERVICES | 45.0 | 124545 | 0 | 9694 | X | ||
| TIM FRANCKA | |||||||
| ADMIN DIR - LONG TERM CARE | 45.0 | 128414 | 0 | 10955 | X | ||
| CHRIS MCBRATNEY | |||||||
| ADMIN DIR - LONG TERM CARE | 45.0 | 106030 | 0 | 13281 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 604749 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 627453 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 129591 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BKD LLP | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS STREET | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 65806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | CONSULTING/AUDIT/TAX | DescriptionOfServices |
| Compensation | 195274 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 84471 | FundraisingEvents |
| All Other Contributions | 3649552 | AllOtherContributions |
| Noncash Contributions | 3127543 | NoncashContributions |
| Total Contributions | 3734023 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 623000 | 33185528 | 33185528 |
| CAFETERIA | 722210 | 94929 | 94929 |
| VENDING | 722210 | 8564 | 8564 |
| TRANSIT | 900099 | 24643 | 24643 |
| OTHER INCOME | 623000 | 15852 | 15852 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 33329516 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 145804 | TotalRevenueColumn |
| Exclusion | $145,804 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2402510 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2532659 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -130149 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -130149 | TotalRevenueColumn |
| Unrelated Business Revenue | 6719 | UnrelatedBusinessRevenue |
| Exclusion | -$136,868 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 280094 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 73210 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 206884 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 206884 | TotalRevenueColumn |
| Exclusion | $206,884 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 43734 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 84471 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 180819 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -137085 | TotalRevenueColumn |
| Exclusion | -$137,085 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| REPAYMENT OF SCHOLARSHIPS | 900099 | 31316 | 31316 | |
| LOSS ON ESTINGUISHMENT OF DEBT | 900099 | -33183 | -$33,183 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -1867 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37147126 | TotalRevenueColumn |
| Related Or Exempt Function Income | 33360832 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 6719 | UnrelatedBusinessRevenue |
| Exclusion | $45,552 | 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 | 9000 | Total |
| Program Services | 9000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71200 | Total |
| Program Services | 71200 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 256697 | Total |
| Management And General | 256697 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14456435 | Total |
| Program Services | 12470668 | ProgramServices |
| Management And General | 1985767 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393869 | Total |
| Program Services | 301561 | ProgramServices |
| Management And General | 92308 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3396112 | Total |
| Program Services | 2685769 | ProgramServices |
| Management And General | 710343 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1201844 | Total |
| Program Services | 977027 | ProgramServices |
| Management And General | 224817 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1830429 | Total |
| Management And General | 1830429 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28996 | Total |
| Management And General | 28996 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154204 | Total |
| Management And General | 154204 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 195086 | Total |
| Program Services | 189786 | ProgramServices |
| Management And General | 5300 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45857 | Total |
| Management And General | 45857 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2268271 | Total |
| Program Services | 1878135 | ProgramServices |
| Management And General | 390136 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186837 | Total |
| Program Services | 62834 | ProgramServices |
| Management And General | 124003 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1146989 | Total |
| Program Services | 792485 | ProgramServices |
| Management And General | 354504 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169426 | Total |
| Program Services | 62140 | ProgramServices |
| Management And General | 107286 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31477 | Total |
| Program Services | 19580 | ProgramServices |
| Management And General | 11897 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 849133 | Total |
| Program Services | 609853 | ProgramServices |
| Management And General | 239280 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1411406 | Total |
| Program Services | 1013681 | ProgramServices |
| Management And General | 397725 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147166 | Total |
| Management And General | 147166 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 251586 | 251586 | |
| MEDICAL SUPPLIES & DRUGS | 2766390 | 2766390 | |
| LICENSES, DUES, SUBSCRIPTIONS | 48733 | 48733 | |
| PROVIDER TAX & FEES | 1980852 | 1980852 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52788 | Total |
| Program Services | 44644 | ProgramServices |
| Management And General | 8144 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33350783 | Total |
| Program Services | 26187191 | ProgramServices |
| Management And General | 7163592 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84530 | BOY |
| EOY | 240805 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4834386 | BOY |
| EOY | 3937883 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117713 | BOY |
| EOY | 476401 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3041712 | BOY |
| EOY | 3192351 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 133867 | BOY |
| EOY | 147100 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 994093 | BOY |
| EOY | 938080 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 60442264 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 24437089 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33448854 | BOY |
| EOY | 36005175 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3372511 | BOY |
| EOY | 2742573 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105762 | BOY |
| EOY | 115383 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 678395 | BOY |
| EOY | 999616 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46811823 | BOY |
| EOY | 48795367 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3881657 | BOY |
| EOY | 4221089 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 133609 | BOY |
| EOY | 148747 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29615000 | BOY |
| EOY | 27820000 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37908 | BOY |
| EOY | 41409 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3828864 | BOY |
| EOY | 3371299 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30197 | BOY |
| EOY | 221709 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37527235 | BOY |
| EOY | 35824253 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7880474 | BOY |
| EOY | 11350264 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1404114 | BOY |
| EOY | 1620850 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9284588 | BOY |
| EOY | 12971114 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46811823 | BOY |
| EOY | 48795367 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3796343 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -109817 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 138156 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 105173 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 158818 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 303900 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3734023 | CurrentTaxYear |
| Total | 4440070 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 29996149 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 30623480 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 30376030 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30715253 | CurrentTaxYearMinus1Year |
| Current Tax Year | 33329516 | CurrentTaxYear |
| Total | 155040428 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 30134305 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 30728653 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 30534848 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 31019153 | CurrentTaxYearMinus1Year |
| Current Tax Year | 37063539 | CurrentTaxYear |
| Total | 159480498 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 159480498 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2009690 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2572519 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2516299 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2479023 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2548314 | CurrentTaxYear |
| Total | 12125845 | Total |
Post1975 UBTI Post1975UBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1818 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3174 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2634 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2161 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2615 | CurrentTaxYear |
| Total | 12402 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2011508 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2575693 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2518933 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2481184 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2550929 | CurrentTaxYear |
| Total | 12138247 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 36680 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 35856 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 30318 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 52733 | CurrentTaxYearMinus1Year |
| Current Tax Year | 31316 | CurrentTaxYear |
| Total | 186903 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 32182493 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 33340202 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 33084099 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 33553070 | CurrentTaxYearMinus1Year |
| Current Tax Year | 39645784 | CurrentTaxYear |
| Total | 171805648 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.92826 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.93022 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.07065 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.06840 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $1,464 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1464 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER LOBBY ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, QUESTION 1I | ReturnReference |
| Explanation | THE ORGANIZATION PAYS ANNUAL DUES TO THE MISSOURI HEALTH CARE ASSOCIATION (MHCA) AND THE AMERICAN HEALTH CARE ASSOCIATION (AHCA). A PORTION OF THESE DUES ARE ALLOCABLE TO LOBBYING: $859 MHCA AND $605 AHCA. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | true | IncludedOnFS |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 4458460 | OtherCostOrOtherBasis |
| Book Value | 4458460 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 47206711 | OtherCostOrOtherBasis |
| Depreciation | 20990605 | Depreciation |
| Book Value | 26216106 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 6350773 | OtherCostOrOtherBasis |
| Depreciation | 2823890 | Depreciation |
| Book Value | 3526883 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 2426320 | OtherCostOrOtherBasis |
| Depreciation | 622594 | Depreciation |
| Book Value | 1803726 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 36005175 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED PARTY | $201,512 |
| PLEDGES PAYABLE | $20,197 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 221709 | TotalOfAmounts |
| Total Revenue | 37147126 | TotalRevenue |
| Total Expenses | 33350783 | TotalExpenses |
| Excess Or Deficit For Year | 3796343 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -119438 | NetUnrealizedGLOnInvestments |
| Other | $9,621 | OtherAmount |
| Total Adjustments | -109817 | TotalAdjustments |
| Excess Or Deficit Per FS | 3686526 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 39472703 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -119438 | NetUnrealizedGainsInvestments |
| Other Revenues | -61579 | OtherRevenues |
| Revenue Not Rptd F990 | -181017 | RevenueNotRptdF990 |
| Revenue Subtotal | 39653720 | RevenueSubtotal |
| Other Revenues Not Included | -2506594 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -2506594 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 37147126 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35786177 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 2506594 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 2506594 | ExpensesNotRptdF990 |
| Expenses Subtotal | 33279583 | ExpensesSubtotal |
| Other Expenses Not Included | 71200 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 71200 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 33350783 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ESCROW ACCOUNT LIABILITY | SCHEDULE D, PART IV, LINE 2B | THE FOUNDATION WAS THE TRUSTEE OF $41,409 AND $37,908, RESPECTIVELY, AT MAY 31, 2012 AND 2011, IN FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS. THE FOUNDATION HAS FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THE BANK ACCOUNTS AND THE DISTRIBUTION OF THE FUNDS TO RESIDENTS. |
| UNCERTAIN TAX POSITION | SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| OTHER CHANGES IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | 9,621 CHANGE IN INVESTMENT IN EQUITY INVESTEE |
| OTHER RECONCILING ITEMS | SCHEDULE D, PART XII, LINE 2D | (71,200) SCHOLARSHIPS GRANTED 9,621 CHANGE IN INVESTMENT IN EQUITY INVESTEE --------- (61,579) TOTAL |
| OTHER RECONCILING ITEMS | SCHEDULE D, PART XII, LINE 4B | (180,819) BURGANDY BALL EXPENSES (2,532,659) RENTAL EXPENSES 206,884 GAIN ON SALE OF FIXED ASSETS ------------ (2,506,594) TOTAL |
| OTHER RECONCILING ITEMS | SCHEDULE D, PART XIII, LINE 2D | 180,819 SPECIAL EVENT EXPENSE 2,532,659 RENTAL EXPENSE (206,884) GAIN ON SALE OF FIXED ASSETS ----------- 2,506,594 TOTAL |
| OTHER RECONCILING ITEMS | SCHEDULE D, PART XIII, LINE 4B | 71,200 SCHOLARSHIPS GRANTED |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 48374 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 38120 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 10254 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 920 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 16508 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 9574 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 680 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 7313 | OtherDirectExpensesEvent1 |
| Name Of Event2 | BURGANDY BALL | NameOfEvent2 |
| Gross Receipts Event2 | 79831 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 46351 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 33480 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 20444 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 33480 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 29429 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 62471 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 128205 | GrossReceiptsTotal |
| Charitable Contributions Total | 84471 | CharitableContributionsTotal |
| Gross Revenue Total Events | 43734 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 920 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 16508 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 30018 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 34160 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 29429 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 69784 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 180819 | DirectExpenseSummaryEvents |
| Net Income Summary | -137085 | NetIncomeSummary |
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 | CITIZENS MEMORIAL HOSPITAL DISTRICT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1 |
| City | BOLIVAR | City |
| State | MO | State |
| ZIP Code | 65613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 431142176 | EINOfRecipient |
| IRC Section | GOVERNMENTAL | IRCSection |
| Amount Of Cash Grant | 9000 | AmountOfCashGrant |
| Purpose Of Grant | SENIOR HEALTH CTR | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | VARIOUS SCHOLARHIPS AWARDED | TypeOfGrant |
| Number Of Recipients | 32 | NumberOfRecipients |
| Amount Of Cash Grant | 71200 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | GRANT MONITORING | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | CITIZENS MEMORIAL HEALTH CARE FOUNDATION HAS A MEDICAL EXCELLENCE SCHOLARSHIP COMMITTEE MADE UP OF BOARD MEMBERS, EMPLOYEES AND COMMUNITY MEMBERS. APPLICATIONS FOR THE SCHOLARSHIP MUST BE SUBMITTED EACH YEAR BY MARCH 1. THE COMMITTEE DETERMINES WHO THE SCHOLARSHIPS ARE AWARDED TO. IF THE AWARDED DOES NOT ENROLL IN A MEDICAL RELATED CLASS TIMELY, THE SCHOLARSHIP IS WITHDRAWN. MANY OF THE PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL AND NOT THE INDIVIDUAL. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | 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 | true | 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)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DONALD J BABB | |||||||||||||
| 89905 | 266707 | 19767 | 0 | 0 | 47120 | 899 | 30746 | 0 | 11961 | 110571 | 356534 | 0 | 0 |
| GARY FULBRIGHT | |||||||||||||
| 0 | 200499 | 0 | 10827 | 0 | 13104 | 0 | 18911 | 0 | 14813 | 0 | 258154 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CRITERIA TO ESTABLISH EXECUTIVE DIRECTOR COMPENSATION | SCHEDULE J, PART I, LINE 3 | THE FOUNDATION'S EXECUTIVE DIRECTOR, DONALD BABB, IS PAID THROUGH CITIZENS MEMORIAL HOSPITAL DISTRICT. AT THE DISTRICT LEVEL, HIS COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS USING COMPARABLE STATISTICS FOR SIMILAR POSITIONS IN THE HEALTHCARE INDUSTRY. |
| CONTINGENT COMPENSATION | SCHEDULE J, PART I, LINE 6 | IN FY 2012, THE FOUNDATION'S BOARD APPROVED TO PAY OUT BONUSES AT 10% OF NET INCOME. THE BONUS IS ALLOCATED TO ALL MANAGEMENT AND STAFF, AND MR. BABB'S ALLOCATION OF THIS BONUS IS SHOWN ON SCHEDULE J, PART II, COLUMN B(II). |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| INDUSTRIAL DVLP AUTHORITY OF THE CITY OF BOLIVAR | |||||||
| 431430093 | 097638BE9 | 2004-12-29 | 4065937 | REFUND 01 & 03 BANK LOANS | false | false | false |
| INDUSTRIAL DVLP AUTHORITY OF DALLAS COUNTY | |||||||
| 431546885 | 234618AC0 | 2004-12-29 | 6477194 | REFUND 1996 BONDS & CONSTRUCTION | false | false | false |
| INDUSTRIAL DVLP AUTHORITY OF POLK COUNTY | |||||||
| 010912805 | 731249AB4 | 2008-08-13 | 10429088 | REFUND 06, 07, & 08 BANK LOANS | false | false | false |
| INDUSTRIAL DVLP AUTHORITY OF THE CITY OF ASH GROVE | |||||||
| 431915231 | 043722AA5 | 2009-07-01 | 2910000 | REFUND SERIES 2001 REV BONDS | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 4110000 | 406900 | 0 | 0 | 81318 | 0 | 0 | 3621782 | 0 | 0 | 2008 | true | false | true | true |
| 0 | 0 | 6575000 | 657500 | 0 | 3323687 | 129543 | 0 | 0 | 2464270 | 0 | 0 | 2008 | false | false | true | true |
| 0 | 0 | 10500000 | 1050000 | 0 | 0 | 208582 | 0 | 0 | 9241418 | 0 | 0 | 2009 | false | false | true | true |
| 0 | 0 | 2910000 | 0 | 0 | 0 | 0 | 0 | 0 | 2910000 | 0 | 0 | 2009 | true | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| false | false | false | false | 0.00000 | 0.00000 | 0.00000 | true |
| false | false | false | false | 0.00000 | 0.00000 | 0.00000 | true |
| false | false | false | false | 0.00000 | 0.00000 | 0.00000 | true |
| 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Business Name Line1NameOfGICProvider/BusinessNameLine1 | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|
| 0 | ||||||
| false | false | false | false | 0 | false | false |
| 0 | ||||||
| false | false | false | false | 0 | false | false |
| 0 | ||||||
| false | false | false | false | 0 | false | false |
| 0 | ||||||
| false | false | false | false | 0 | false | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|
| INDUSTRIAL DVLP AUTHORITY OF THE CITY OF BOLIVAR | ||||||
| 431430093 | 2009-12-15 | 3310000 | REFUND SERIES 1998 REV BONDS | false | false | false |
| INDUSTRIAL DVLP AUTH OF THE CITY OF ELDORADO SPRGS | ||||||
| 260025115 | 2012-01-27 | 2680000 | REFUND SERIES 2001 REV BONDS | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 3310000 | 0 | 0 | 0 | 0 | 0 | 0 | 3310000 | 0 | 0 | 2009 | true | false | true | true |
| 0 | 0 | 2680000 | 0 | 0 | 0 | 0 | 0 | 0 | 2680000 | 0 | 0 | 2012 | true | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers |
|---|
| 0 |
| 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Business Name Line1NameOfGICProvider/BusinessNameLine1 | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|
| 0 | ||||||
| false | false | false | false | 0 | false | false |
| 0 | ||||||
| false | false | false | false | 0 | false | false |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArt | |
| Art Historical Treasures | ArtHistoricalTreasures | |
| Art Fractional Interest | ArtFractionalInterest | |
| Books And Publications | BooksAndPublications | |
| Clothing And Household Goods | ClothingAndHouseholdGoods | |
| Cars And Other Vehicles | CarsAndOtherVehicles | |
| Boats And Planes | BoatsAndPlanes | |
| Intellectual Property | IntellectualProperty | |
| Securities Publicly Traded | SecuritiesPubliclyTraded | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStock | |
| Securities Prtnrshp Trust Intrsts | SecuritiesPrtnrshpTrustIntrsts | |
| Securities Miscellaneous | SecuritiesMiscellaneous | |
| Qualified Contrib Hist Struct | QualifiedContribHistStruct | |
| Qualified Contrib Other | QualifiedContribOther | |
| Real Estate Residential | RealEstateResidential |
Real Estate Commercial RealEstateCommercial
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 3127543 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real Estate Other | RealEstateOther | |
| Collectibles | Collectibles | |
| Food Inventory | FoodInventory | |
| Drugs And Medical Supplies | DrugsAndMedicalSupplies | |
| Taxidermy | Taxidermy | |
| Historical Artifacts | HistoricalArtifacts | |
| Scientific Specimens | ScientificSpecimens | |
| Archaeological Artifacts | ArchaeologicalArtifacts | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD OF DETERMINING NONCASH CONTRIBUTION AMOUNTS | Identifier |
| Return Reference | SCHEDULE M, PART I, COLUMN D | ReturnReference |
| Explanation | ON SEPTEMBER 1, 2011, CITIZENS MEMORIAL HEALTH CARE FOUNDATION ENTERED INTO A MERGER WITH ANOTHER MISSOURI NON-PROFIT CORPORATION. THE ORGANIZATION RECOGNIZED THIS MERGER AS A CONTRIBUTION WITH A NET VALUE OF $3,127,543. THIS AMOUNT IS CALCULATED AS FOLLOWS: 42,513 ACCOUNTS RECEIVABLE 5,846 INVENTORY 2,925 OTHER RECEIVABLES 2,203,796 BUILDING 80,000 LAND 362,570 FURNITURE, FIXTURES & EQUIPMENT 524,000 CERTIFICATE OF NEED 8,438 COST REPORT SETTLEMENT (74,444) PTO ACCRUED (3,200) MCR LEVEL PAYMENTS (15,027) ACCRUED NFRA (9,874) OTHER LIABILITIES ---------- 3,127,543 TOTAL | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 | THE ORGANIZATION WAS CREATED TO SUPPORT CMH HOSPITAL DISTRICT THROUGH LONG TERM CARE SERVICES SUCH AS SKILLED NURSING FACILITIES, RESIDENTIAL CARE FACILITIES AND INDEPENDENT LIVING APARTMENTS, AND TO PROVIDE SERVICES TO THE LOCAL RURAL COMMUNITIES SUCH AS MEDICAL EQUIPMENT AND SUPPLIES, HEALTH TRANSPORTATION AND HOMEMAKER CHORE SERVICES. |
| NUMBER OF VOLUNTEERS | FORM 990, PART I, LINE 6 | THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS ALONG WITH OTHER AUXILIARY VOLUNTEERS WHO ASSIST WITH A VARIETY OF OPPORTUNITIES AT THE FOUNDATION'S FACILITIES. |
| CHANGES IN PROGRAM SERVICES | FORM 990, PART III, LINE 3 | IN SEPTEMBER OF 2011 THE ORGANIZATION ACQUIRED LAKE STOCKTON HEALTH CARE FACILITY, A 75-BED MEDICAID-CERTIFIED AND MEDICARE-CERTIFIED NURSING CARE FACILITY LOCATED IN STOCKTON, MO. THIS FACILITY EXPANDS THE ORGANIZATIONS ABILITY TO PROVIDE LONG TERM CARE SERVICES TO THE RESIDENTS IN AND AROUND STOCKTON, MO. |
| PROGRAM SERVICE ACTIVITY DETAIL | FORM 990, PART III, LINES 4A, 4B, 4C & 4D | WE OFFER CARE AT EVERY STAGE OF LIFE BY PROVIDING HOME CARE, INDEPENDENT LIVING, RESIDENTIAL CARE AND SKILLED NURSING (LONG TERM CARE) FACILITIES. ALL FACILITIES OFFER RESIDENT AND FAMILY SERVICES INCLUDING SOCIAL SERVICES; DAILY ACTIVITIES AND MONTHLY OUTINGS; BEAUTY AND BARBER SERVICES; VISITS FROM COMMUNITY AND SCHOOL ORGANIZATIONS; AND LAUNDRY, CHURCH AND PHARMACY SERVICES. MONTHLY FAMILY SUPPORT GROUPS AND RESIDENT CARE PLANNING MEETINGS ASSIST FAMILY MEMBERS WITH EDUCATION AND RESOURCES TO ENHANCE THE QUALITY OF TIME SHARED WITH LOVED ONE. IN ADDITION, IF PATIENTS NEED A LITTLE EXTRA HELP, HOMEMAKER PLUS CAN HELP THEM REMAIN INDEPENDENT IN THEIR HOME. OUR SERVICES ARE PROVIDED ON A NONDISCRIMINATORY BASIS AND CAN BENEFIT EVERYONE, FROM THE ELDERLY AND PHYSICALLY CHALLENGED TO THE HEALTHY FAMILY ON THE GO. A CARING INDIVIDUAL WILL VISIT THE HOME AND ASSIST PATIENTS ON A LONG-TERM OR ONE-TIME BASIS WITH PERSONAL CARE SERVICES, HOUSEKEEPING CHORES, MEAL PLANNING, GROCERY SHOPPING AND A HOST OF OTHER IMPORTANT SERVICES. |
| BOARD MEMBER BUSINESS RELATIONSHIP | FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS BRAD GREGORY AND DAVE STRADER HAVE A BUSINESS RELATIONSHIP. |
| 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 WILL BE REVIEWED BY TOP MANAGEMENT. A FINAL DRAFT WILL BE DISCUSSED AT A MEETING OF THE FULL BOARD OF DIRECTORS. |
| CONFLICT OF INTEREST POLICY REVIEW | FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, DURING THE MARCH BOARD OF DIRECTOR'S MEETING, THE OFFICERS AND DIRECTORS DISCLOSE ALL KNOWN CONFLICTS OF INTEREST. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. IN ADDITION, ALL CORPORATE OFFICERS AND KEY EMPLOYEES ARE ANNUALLY REQUIRED TO REPORT POTENTIAL CONFLICTS OF INTEREST. |
| COMPENSATION REVIEW POLICY | FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS OF CITIZENS MEMORIAL HOSPITAL DISTRICT ESTABLISHES THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER/EXECUTIVE DIRECTOR BASED UPON COMPENSATION FOR SIMILAR POSITIONS IN THE HEALTHCARE INDUSTRY. A WRITTEN EMPLOYMENT AGREEMENT DETAILS THE SALARY AND BENEFITS FOR THE CEO/EXECUTIVE DIRECTOR. CITIZENS MEMORIAL HEALTH CARE FOUNDATION PAYS A PERCENTAGE OF THE TOTAL BASED UPON THE ESTIMATED PERCENTAGE OF TIME SPLIT BETWEEN THE TWO ORGANIZATIONS. THIS PERCENTAGE IS NOT ANNUALLY REVIEWED OR APPROVED BY THE CITIZENS MEMORIAL HOSPITAL DISTRICT BOARD OF DIRECTORS. |
| DOCUMENT DISCLOSURE | FORM 990, PART VI, SECTION C, LINE 19 | MANY ORGANIZATION POLICIES ARE MADE AVAILABLE TO EMPLOYEES ON THE COMPANY INTRANET, FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST TO ALL BONDHOLDERS FOR A LEGITIMATE BUSINESS PURPOSE, AND THE AUDIT REPORT IS MADE AVAILABLE TO ALL LENDERS. IN GENERAL, DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC BY ANY OTHER MEANS. |
| HOURS FOR A RELATED ORGANIZATION | FORM 990, PART VII, COLUMN B | DONALD J. BABB, GARY FULBRIGHT, AND CATHERINE MOLDER EACH WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR CITIZENS MEMORIAL HOSPITAL. |
| MANAGEMENT FEES | FORM 990, PART IX, LINE 11A | MANAGEMENT FEES REPORTED ON LINE 11A REPRESENTS THE FOUNDATION'S PORTION OF EXPENSES RELATING TO DEPARTMENTS SHARED WITH CITIZENS MEMORIAL HOSPITAL, A RELATED PARTY. AT NO POINT DURING THE YEAR DID THE FOUNDATION DELEGATE MANAGERIAL DUTIES TO THE HOSPITAL. |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | FORM 990, PART XI, LINE 5 | 119,438 NET UNREALIZED GAIN ON INVESTMENT (9,621) CHANGES IN INVESTMENT IN EQUITY INVESTEE -------- 109,817 TOTAL |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CITIZENS MEMORIAL HOSPITAL | ||||||||||
| 1500 N OAKLAND | BOLIVAR | MO | 65613 | 431142176 | HOSPITAL | MO | 501(C)(3) | 3 | NA | false |
| RIVERSIDE MANAGEMENT & REHABILITATION | ||||||||||
| 1500 N OAKLAND | BOLIVAR | MO | 65613 | 431776752 | MGT & REHAB | MO | 501(C)(3) | 9 | NA | false |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOLIVAR MED BLDG | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOLIVAR MO 65613 | AddressLine1 |
| City | BOLIVAR | City |
| State | MO | State |
| ZIP Code | 65613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262797636 | EIN |
| Primary Activity | MEDICAL BUILD | PrimaryActivity |
| Legal Domicile State | MO | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMHCF | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | EXCLUDED FROM TAX | PredominantIncomeType |
| Share Of Total Income | 7503 | ShareOfTotalIncome |
| Share Of EOY Assets | 388047 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| Code V | $0 | CodeVAmount |
| General Or Managing Partner | false | GeneralOrManagingPartner |
| Percentage Ownership | 0.51000 | PercentageOwnership |
| 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 | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| 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 | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOLIVAR MEDICAL BUIDLING LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | J | TransactionType |
| Amount Involved | 92074 | AmountInvolved |
| Method Of Amt Determination | FMV | MethodOfAmtDetermination |