COMMUNITY MEMORIAL HEALTHCARE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEMORIAL HEALTHCARE INC (EIN 48-0630224)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201323199349304902
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T11:11:55-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | 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 | 1201 Walnut Suite 1700 | AddressLine1 |
| City | Kansas City | City |
| State | MO | State |
| ZIP Code | 641062246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480630224 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Memorial Healthcare Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % WILLIAM H STORCK | InCareOfName |
| Name Control | COMM | NameControl |
| Phone | 7855622311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18th Street | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Marysville | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM H STORCK | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 7855622311 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kevin Ensminger CPA | Name |
| Phone | 8162216300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CURTIS R HAWKINSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1 |
| City | MARYSVILLE | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19657842 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CMHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | COMMUNITY MEMORIAL HEALTHCARE, INC. IS A NOT-FOR-PROFIT MEMBERSHIP CORPORATION THAT OWNS AND OPERATES A GENERAL ACUTE CARE HOSPITAL FOR PATIENTS IN MARYSVILLE, KANSAS AND SURROUNDING AREAS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 270 | TotalNbrEmployees |
| Total Nbr Volunteers | 12 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 283786 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 109939 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18724953 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 19426349 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -2445 | InvestmentIncomePriorYear |
| Investment Income Current Year | 118178 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 19006294 | TotalRevenuePriorYear |
| Total Revenue Current Year | 19654466 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10734212 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11028043 | 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 | 8969907 | OtherExpensePriorYear |
| Other Expenses Current Year | 10180338 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19706119 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21208381 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -699825 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1553915 | RevenuesLessExpensesCY |
| Total Assets BOY | 30249347 | TotalAssetsBOY |
| Total Assets EOY | 28646182 | TotalAssetsEOY |
| Total Liabilities BOY | 18936375 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 18735863 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 11312972 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9910319 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION STATEMENT OF COMMUNITY MEMORIAL HEALTHCARE, INC. IS TO EXCEL AT CARING FOR YOU. THE VISION STATEMENT OF COMMUNITY MEMORIAL HEALTHCARE, INC. IS TO EXCEED EXPECTATIONS AS A TRUSTED AND VALUED HEALTH PROVIDER. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 3509288 | Expense |
| Grants | 0 | Grants |
| Revenue | 2505480 | Revenue |
| Description | EMERGENCY ROOM SERVICES, RESPIRATORY SERVICES, DURABLE MEDICAL EQUIPMENT SALES, AND HOME HEALTH SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6028577 | Expense |
| Grants | 0 | Grants |
| Revenue | 2446307 | Revenue |
| Description | ADULT AND PEDIATRIC INPATIENT ACUTE CARE SERVING 3,795 PATIENT DAYS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4571516 | Expense |
| Grants | 0 | Grants |
| Revenue | 9436083 | Revenue |
| Description | DIAGNOSTIC IMAGING INPATIENT AND OUTPATIENT PERFORMING 9,286 SCANS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 3225913 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 5038479 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 17335294 | 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 | false | CreditCounseling |
| Term Or Permanent Endowments | true | 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 | false | 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 | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| 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 | true | 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 | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 32 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 270 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | 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 | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | WILLIAM H STORCK | NamePerson |
| Telephone Number | 7855622311 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1 |
| City | MARYSVILLE | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| AMOS ALSTROM | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| MARGE SCHLABACH | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| DONA BRUNA | ||||||||
| VICE-CHAIRPERSON/DIRECTOR | 4.0 | X | 0 | 0 | 0 | X | ||
| DAN CAFFREY | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| KEN KICKHAFER | ||||||||
| CHAIRPERSON/DIRECTOR | 4.0 | X | 0 | 0 | 0 | X | 1.0 | |
| TRENT MOSER | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | 1.0 | ||
| DAVID HAMEL | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| JERRY ZANKER | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | 1.0 | ||
| WILLIAM OBORNY | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| JOHN SCHWARTZ | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | 1.0 | ||
| DELORES STUMP | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| ED HENRY | ||||||||
| DIRECTOR | 4.0 | X | 0 | 0 | 0 | |||
| DR JOHN RYAN | ||||||||
| CHIEF OF STAFF/ DIRECTOR | 40.0 | X | 248237 | 0 | 26477 | X | ||
| CURTIS R HAWKINSON | ||||||||
| CEO | 40.0 | 144073 | 0 | 20469 | X | 1.0 | ||
| WILLIAM H STORCK | ||||||||
| CFO | 40.0 | 95631 | 0 | 16016 | X | |||
| DR JOHN HAEFELE | ||||||||
| DIR OF RT, OT, ST, REF CLINIC | 40.0 | 226106 | 0 | 26987 | X | |||
| DR RANDALL BROWN | ||||||||
| DIRECTOR OF OB, CARDIAC, HIM | 40.0 | 286959 | 0 | 28316 | X | |||
| DR JOSEPH HAWKINS | ||||||||
| DIRECTOR OF SLEEP, HHA, PHARM | 40.0 | 222844 | 0 | 15897 | X | |||
| DR KENNETH DUENSING | ||||||||
| DIRECTOR OF PT, NS, SAFETY | 40.0 | 213172 | 0 | 25012 | X | |||
| DR FERNANDO UGARTE | ||||||||
| DIRECTOR OF SURGERY, ANES | 40.0 | 233690 | 0 | 27000 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1670712 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 186174 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| CRIST PIESCHEL PT | |
| PHYSICAL THERAPY | 722129 |
| MARYSVILLE ANESTHESIA | |
| ANESTHESIOLOGIST | 397773 |
| NEBRASKA HEART INST | |
| CARDIO TESTS | 220995 |
| SE NE MOBILE DIAG SERVS | |
| ULTRASOUND & MAMO | 190318 |
| CPSI | |
| COMPUTER SERVICES | 236103 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Fundraising Events | 0 | FundraisingEvents |
| Government Grants | 5000 | GovernmentGrants |
| All Other Contributions | 104939 | AllOtherContributions |
| Total Contributions | 109939 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Service Revenue | 621400 | 19291054 | 19291054 |
| Dietary Income | 624200 | 101892 | 101892 |
| Other Operating Revenue | 900099 | 33403 | 33403 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 19426349 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107719 | TotalRevenueColumn |
| Exclusion | $107,719 | 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 |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13835 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3376 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 10459 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10459 | TotalRevenueColumn |
| Exclusion | $10,459 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19654466 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19426349 | RelatedOrExemptFunctionIncome |
| Exclusion | $118,178 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 512897 | Total |
| Program Services | 396689 | ProgramServices |
| Management And General | 116208 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72009 | Total |
| Program Services | 55493 | ProgramServices |
| Management And General | 16516 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8277617 | Total |
| Program Services | 6371939 | ProgramServices |
| Management And General | 1905678 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286928 | Total |
| Program Services | 210068 | ProgramServices |
| Management And General | 76860 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1267172 | Total |
| Program Services | 1075990 | ProgramServices |
| Management And General | 191182 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 611420 | Total |
| Program Services | 559769 | ProgramServices |
| Management And General | 51651 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9647 | Total |
| Management And General | 9647 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142261 | Total |
| Management And General | 142261 | 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 | 2553676 | Total |
| Program Services | 2311274 | ProgramServices |
| Management And General | 242402 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81445 | Total |
| Program Services | 79999 | ProgramServices |
| Management And General | 1446 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228442 | Total |
| Program Services | 183984 | ProgramServices |
| Management And General | 44458 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 805298 | Total |
| Program Services | 764803 | ProgramServices |
| Management And General | 40495 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165437 | Total |
| Program Services | 134073 | ProgramServices |
| Management And General | 31364 | 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 | 8030 | Total |
| Management And General | 8030 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 801774 | Total |
| Program Services | 19389 | ProgramServices |
| Management And General | 782385 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1605416 | Total |
| Program Services | 1538551 | ProgramServices |
| Management And General | 66865 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235733 | Total |
| Program Services | 138132 | ProgramServices |
| Management And General | 97601 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 1243505 | 1243505 | |
| MEDICAL SUPPLIES | 1808101 | 1808101 | |
| EQUIP RENTAL & MAINTENANCE | 372769 | 362318 | 10451 |
| DUES & SUBSCRIPTIONS | 77651 | 42815 | 34836 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41153 | Total |
| Program Services | 38402 | ProgramServices |
| Management And General | 2751 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21208381 | Total |
| Program Services | 17335294 | ProgramServices |
| Management And General | 3873087 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1055 | BOY |
| EOY | 34300 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2316453 | BOY |
| EOY | 1909662 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 148422 | BOY |
| EOY | 73845 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3917219 | BOY |
| EOY | 3090497 | 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 | 493997 | BOY |
| EOY | 436924 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 256857 | BOY |
| EOY | 244698 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 26543473 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7907942 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18355952 | BOY |
| EOY | 18635531 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4142391 | BOY |
| EOY | 3821793 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60279 | 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 | 556722 | BOY |
| EOY | 398932 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30249347 | BOY |
| EOY | 28646182 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1632154 | BOY |
| EOY | 1689214 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 17304221 | BOY |
| EOY | 17046649 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18936375 | BOY |
| EOY | 18735863 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10072144 | BOY |
| EOY | 9760680 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1165034 | BOY |
| EOY | 73845 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75794 | BOY |
| EOY | 75794 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11312972 | BOY |
| EOY | 9910319 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30249347 | BOY |
| EOY | 28646182 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1553915 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 135762 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 15500 | 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 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 | |
| Form4720 Filed | false | Form4720Filed |
| 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 | true | GrantsOtherOrganizations |
| Grants Other Organizations | $4,313 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 4313 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1(F) | ReturnReference |
| Explanation | DUES PAID TO THE KANSAS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3126013 | BeginningOfYearBalance |
| Contributions | 9249 | Contributions |
| Investment Earnings Or Losses | 68612 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1000 | GrantsOrScholarships |
| Other Expenditures | 2066944 | OtherExpenditures |
| Administrative Expenses | 1106 | AdministrativeExpenses |
| End Of Year Balance | 1134824 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2859086 | BeginningOfYearBalance |
| Contributions | 266927 | Contributions |
| Investment Earnings Or Losses | 4502 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 2502 | AdministrativeExpenses |
| End Of Year Balance | 3126013 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2367441 | BeginningOfYearBalance |
| Contributions | 491645 | Contributions |
| Investment Earnings Or Losses | 2944 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 944 | AdministrativeExpenses |
| End Of Year Balance | 2859086 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1716790 | BeginningOfYearBalance |
| Contributions | 650651 | Contributions |
| Investment Earnings Or Losses | 2121 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 121 | AdministrativeExpenses |
| End Of Year Balance | 2367441 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1060979 | BeginningOfYearBalance |
| Contributions | 655811 | Contributions |
| Investment Earnings Or Losses | 3613 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 1613 | AdministrativeExpenses |
| End Of Year Balance | 1716790 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.86810 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.06680 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.06510 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 81530 | OtherCostOrOtherBasis |
| Book Value | 81530 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20339451 | OtherCostOrOtherBasis |
| Depreciation | 3542004 | Depreciation |
| Book Value | 16797447 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5889798 | OtherCostOrOtherBasis |
| Depreciation | 4250452 | Depreciation |
| Book Value | 1639346 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 232694 | OtherCostOrOtherBasis |
| Depreciation | 115486 | Depreciation |
| Book Value | 117208 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18635531 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 18628653 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 135762 | NetUnrealizedGainsInvestments |
| Other Revenues | 122900 | OtherRevenues |
| Revenue Not Rptd F990 | 258662 | RevenueNotRptdF990 |
| Revenue Subtotal | 18369991 | RevenueSubtotal |
| Other Revenues Not Included | 1284475 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1284475 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 19654466 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 20007983 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 43107 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 43107 | ExpensesNotRptdF990 |
| Expenses Subtotal | 19964876 | ExpensesSubtotal |
| Other Expenses Not Included | 1243505 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1243505 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 21208381 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ENDOWMENT FUNDS | SCHEDULE D, PART V, LINE 4 | BOARD-DESIGNATED ASSETS LIMITED TO USE OF $985,141 INCLUDE ASSETS SET ASIDE BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL IMPROVEMENTS AND OPERATIONS OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE THE ASSETS FOR OTHER PURPOSES. TEMPORARY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE ORGANIZATION HAS BEEN LIMITED BY DONORS TO A SPECIFIC TIME OR PERIOD. TEMPORARY RESTRICTED ASSETS OF $75,806 ARE USED TO FUND CONSTRUCTION OF THE NEW UPCOMING BUILDING. PERMANENTLY RESTRICTED ASSETS OF $73,877 HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY CMH IN PERPETUITY WITH THE INCOME TO BE USED FOR SCHOLARSHIPS. |
| UNCERTAIN TAX POSITIONS DISCLOSURE | 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 - REVENUE INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 | SCHEDULE D, PART XI, LINE 2D | RELATED ORGANIZATION REVENUE $ 122,900 |
| OTHER - REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1 | SCHEDULE D, PART XI, LINE 4B | RESTRICTED ENDOWMENT CONTRIBUTIONS $ 40,970 BAD DEBT EXPENSE $1,243,505 ---------- $1,284,475 |
| OTHER - EXPENSES INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 | SCHEDULE D, PART XII, LINE 2D | RELATED ORGANIZATION EXPENSES $ 43,107 |
| OTHER - EXPENSES INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | BAD DEBT EXPENSE $1,243,505 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 278218 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 278218 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01390 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 339453 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 302746 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 36707 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 617671 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 302746 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 314925 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01570 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37277 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10308 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 26969 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37277 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10308 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 26969 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 654948 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 313054 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 341894 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01580 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $1,243,505 | BadDebtExpenseAmount |
| Amount Attributable To | 62175 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 9210127 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 9648997 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -438870 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| 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 | COMMUNITY MEMORIAL HEALTHCARE INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1 |
| City | MARYSVILLE | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HEALTHCARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 150. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 150. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| 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 |
| 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 | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Community Physicians Clinic | ||||
| 1902 MAY | MARYSVILLE | KS | 66508 | RURAL HEALTH CLINIC |
| Marysville Clinic | ||||
| 808 N 19th | Marysville | KS | 66508 | RURAL HEALTH CLINIC |
| Blue Rapids Medical Clinic | ||||
| 607 lincoln | BLUE RAPIDS | KS | 66411 | RURAL HEALTH CLINIC |
| Community Medical Equipment | ||||
| 805 Broadway | Marysville | KS | 66508 | Durable Medical Equipment |
| CMH Home Health | ||||
| 910 Broadway | Marysville | KS | 66508 | Home Health Agency |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| METHOD USED TO DETERMINE THE COST-TO-CHARGE RATIO | SCHEDULE H, PART I, LINE 7(A) | THE COST-TO-CHARGE RATIO WAS USED AS THE COSTING METHODOLOGY TO REPORT CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| AMOUNT OF BAD DEBT REMOVED FROM PART I, LINE 7, CALCULATION | SCHEDULE H, PART I, LINE 7(F) | THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), SUBTRACTED FOR PURPOSES OF CALCULATING SCHEDULE H, PART I, LINE 7(F) IS $1,243,505. |
| METHOD USED TO ESTIMATE PORTION OF BAD DEBT AS COMMUNITY BENEFIT | SCHEDULE H, PART III, LINE 3 | THE ORGANIZATION USES A HISTORIC RATE OF SELF-PAY PATIENTS (5%) AND APPLIES IT TO BAD DEBT EXPENSE. |
| METHOD USED TO DETERMINE BAD DEBT EXPENSE | SCHEDULE H, PART III, LINE 4 | CMHs allowance for doubtful accounts for self-pay patients increased from 64% of self-pay accounts receivable at December 31, 2011, to 71% of self-pay accounts receivable at December 31, 2012. In addition, CMHs write-offs increased approximately $581,000 from approximately $302,000 for the year ended December 31, 2011, to approximately $883,000 for the year ended December 31, 2012. Both increases were the result of negative trends experienced in the collection of amounts from self-pay patients in fiscal year 2012. CMH REPORTS PATIENT ACCOUNTS RECEIVABLES FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD PARTY PAYERS, PATIENTS, AND OTHERS. CMH PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTIVE INFORMATION AND EXISTING ECONOMIC CONDITIONS. THE AMOUNT ON LINE THREE WAS CALCULATED BY TAKING A RATIO OF CHARITY CARE TO NET PATIENT SERVICE REVENUE AND APPLYING THAT RATIO TO BAD DEBT. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. The costing methodology used for lines 2 and 3 was the cost to charge ratio from the 2012 Medicare cost report. Line 3 was taken from the Medicare Bad debt schedule prepared for the 2012 cost report. |
| COSTING METHODOLOGY USED TO DETERMINE ALLOWABLE MEDICARE COSTS | SCHEDULE H, PART III, LINE 8 | THERE WAS A SHORTFALL RELATING TO THE MEDICARE REVENUE RECEIVED AND RELATED ALLOWABLE MEDICARE COSTS. THE COSTING METHODOLOGY USED TO DETERMINE THESE AMOUNTS CAME FROM THE ORGANIZATION'S MEDICARE COST REPORT. THE SHORTFALL FROM LINE SEVEN REPRESENTS LEGITIMATE EXPENSES/COSTS INCURRED BY THE HOSPITAL TO SERVE MEDICARE PATIENTS. THESE ARE COSTS SIMILAR TO CHARITY CARE IN THAT THE HOSPITAL DID NOT COLLECT THESE FUNDS. AS SUCH THERE IS A DIRECT BENEFIT DERIVED FOR THE COMMUNITY IN THAT THE HOSPITAL WAS ABLE TO PROVIDE CARE FOR THESE PATIENTS. THEREFORE THE ENTIRE SHORTFALL SHOULD BE COUNTED AS A COMMUNITY BENEFIT. |
| COLLECTION PRACTICES FROM PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE | SCHEDULE H, PART III, LINE 9B | CMH RECOGNIZES THE FACT THAT SOME PATIENTS WILL NEED ASSISTANCE IN MEETING THEIR FINANCIAL OBLIGATIONS ON PATIENT ACCOUNTS. FOR THESE PATIENTS, THE FINANCIAL ASSISTANCE POLICY HAS BEEN ESTABLISHED. THIS POLICY MANDATES THAT NOTICE OF THE POLICY BE POSTED AT INPATIENT, OUTPATIENT, AND CLINIC ADMISSIONS AREAS. IT FURTHER MANDATES THAT "DURING THE COLLECTION PROCESS, CMH WILL AGAIN NOTIFY PATIENTS OF OUR PATIENT FINANCIAL ASSISTANCE POLICY". |
| NEEDS ASSESSMENT | SCHEDULE H, PART VI, LINE 2 | In addition to conducting its own research, CMH collaborates through the interagency cooperative council (a collection of county wide not-for-profit agencies) to assess the needs of Marshall County. CMH is in the process of conducting and complying with the requirements of 501(r). The CHNA will be published by 12/31/2013. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | The insurance office personnel explain eligibility to patients and will assist with paperwork. The availability of Financial asistance is posted throughout the building (i.e. the business office, the clinics, Emergency department). Patients who are identified either before services are rendered or prior to discharge are contacted by the business office personnel to assess qualification for Medicaid or Financial assistance. Business office personnel attempt to contact patients via phone and mail regarding their bill. Part of the charity care program is to attempt enrollment into the medicaid program. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4 | Community Memorial Healthcare, Inc. is a not-for-profit membership corporation that owns and operates a general acute care hospital. CMH primarily earns revenues by providing inpatient, outpatient, emergency, clinic and home health services to Marysville, Blue Rapids, Beattie, Hanover, Waterville, Washington, Frankfort, Axtell and Home Kansas. These areas are also served by Hanover Hospital (Hanover, KS), Nemaha Valley Community Hospital (Seneca, KS), Mercy Regional Health Center (Manhattan, KS), Bryan LGH Health System (Lincoln, NE), Saint Elizabeth Regional Medical Center (Lincoln, NE), Saint Francis Health Center (Topeka, KS), Stormont-Vail Healthcare (Topeka, KS). As of the 2000 census, the city of Marysville had a total population of 3,271, while Marshall County population was 10,965. BELOW ARE ADDITIONAL MARSHALL COUNTY DEMOGRAPHICS: 22% of the population is over 65 years of age. 28% of the population is between 45-64 years of age. 28% of the population is between the ages of 18-44. Median household income for Marshall county was $48,000 for 2008. Unemployment in Marshall county is 4.6%. 9.2% of the population are living below the poverty level. The hospital is the third largest employer in the county. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5 | Community Memorial Healthcare provides personnel and supplies to teach CPR classes for a nominal fee to the general public and local first responders. The hospital sponsors an annual healthfare for the general public drawing blood and runs diagnostic tests. The Hospital sponsors tours of local grocers with the intent of teaching community members how to read and understand nutrition labels and make healthy choices when purchasing groceries. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | 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 (7 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR JOHN RYAN | ||||||||||||||
| CHIEF OF STAFF/ DIRECTOR | 47088 | 0 | 196888 | 0 | 4261 | 0 | 13542 | 0 | 12935 | 0 | 274714 | 0 | 0 | 0 |
| CURTIS R HAWKINSON | ||||||||||||||
| CEO | 136545 | 0 | 0 | 0 | 7529 | 0 | 6334 | 0 | 14135 | 0 | 164542 | 0 | 0 | 0 |
| DR JOHN HAEFELE | ||||||||||||||
| DIR OF RT, OT, ST, REF CLINIC | 35829 | 0 | 184791 | 0 | 5486 | 0 | 12127 | 0 | 14860 | 0 | 253093 | 0 | 0 | 0 |
| DR RANDALL BROWN | ||||||||||||||
| DIRECTOR OF OB, CARDIAC, HIM | 27868 | 0 | 240543 | 0 | 18548 | 0 | 13647 | 0 | 14669 | 0 | 315275 | 0 | 0 | 0 |
| DR JOSEPH HAWKINS | ||||||||||||||
| DIRECTOR OF SLEEP, HHA, PHARM | 40566 | 0 | 167699 | 0 | 14579 | 0 | 3037 | 0 | 12860 | 0 | 238741 | 0 | 0 | 0 |
| DR KENNETH DUENSING | ||||||||||||||
| DIRECTOR OF PT, NS, SAFETY | 42430 | 0 | 169556 | 0 | 1187 | 0 | 11152 | 0 | 13860 | 0 | 238184 | 0 | 0 | 0 |
| DR FERNANDO UGARTE | ||||||||||||||
| DIRECTOR OF SURGERY, ANES | 212879 | 0 | 0 | 0 | 20811 | 0 | 12624 | 0 | 14376 | 0 | 260690 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF COMPENSATION CONTINGENT OF REVENUES | Identifier |
| Return Reference | SCHEDULE J, PART I, LINE 5A | ReturnReference |
| Explanation | PHYSICIAN COMPENSATION IS BASED ON A PRODUCTION COMPONENT OF THEIR SERVICES. PHYSICIANS RECEIVE AS COMPENSATION, A PERCENTAGE OF CERTAIN QUALIFIED PROCEDURES IN WHICH THEY PERFORM. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SEE SCHEDULE L PART V | NamePerson |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS WITH INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV | ReturnReference |
| Explanation | BOARD MEMBER- TRENT MOSER (A) KELLY MOSER (B) SPOUSE (C) $19,509 (D) COMPENSATION (E) NO BOARD MEMBER/OFFICER- JOHN RYAN (A) JILL RYAN (B) SPOUSE (C) $52,500 (D) COMPENSATION (E) NO | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER PROGRAM SERVICES | FORM 990, PART III, LINE 4D | LABORATORY SERVICES INPATIENT AND OUTPATIENT 237,126 TESTS AND 115 BLOOD TRANSFUSIONS. |
| MEMBERS | FORM 990, PART VI, SECTION A, LINE 6 | ANY PERSON, FIRM, ASSOCIATION, CORPORATION, OR BODY POLITIC, OR SUBDIVISION THEREOF, MAY BECOME A MEMBER OF THE COMMUNITY MEMORIAL HEALTHCARE, INC. BY: (A) PAYING A MEMBERSHIP FEE OF $100.00; AND (B) AGREEING TO COMPLY WITH AND BE BOUND BY THE ARTICLES OF INCORPORATION AND BYLAWS AND ANY RULES AND REGULATIONS ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION. |
| MEMBERS MAY ELECT GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7A | A CERTIFICATE OF MEMBERSHIP SHALL ENTITLE THE LEGAL HOLDER TO ONE VOTE UPON MATTERS SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS. WHERE THE LEGAL HOLDER OF THE CERTIFICATE IS A FIRM, ASSOCIATION, CORPORATION, OR A BODY POLITIC, OR A SUBDIVISION THEREOF, THE PRESIDENT, CHIEF EXECUTIVE OFFICER OR HIS DESIGNEE SHALL CAST THE VOTE. ALL QUESTIONS REQUIRING A VOTE OF THE MEMBERS SHALL BE DECIDED BY A VOTE OF A MAJORITY OF THE MEMBERS PRESENTING PERSON EXCEPT AS OTHERWISE PROVIDED BY LAW, THE ARTICLES OF INCORPORATION OR THE BYLAWS. |
| GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PART VI, SECTION A, LINE 7B | 1. ANY SALE, LEASE, OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF CORPORATE PROPERTY AND ASSETS OR ANY DISSOLUTION OF THE CORPORATION SHALL BE GOVERNED BY K.S.A. 17-6801 ET SEQ., REQUIRING A MAJORITY VOTE OF THE MEMBERS ENTITLED TO VOTE THEREON AT A DULY CALLED MEETING OF THE MEMBERS. 2. THE BYLAWS MAY NOT BE AMENDED, REVISED, OR REPEALED WITHOUT VOTE BY THE MEMBERSHIP. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | THE CFO GATHERS INFORMATION TO PREPARE THE FORM 990 TAX RETURN. THIS INFORMATION IS THEN GIVEN TO AN INDEPENDENT ACCOUNTING FIRM WHO PREPARES AND REVIEWS THE FORM 990. THE INDEPENDENT ACCOUNTING FIRM THEN PROVIDES THE CFO AND FINANCE COMMITTEE A DRAFT OF THE FORM 990 FOR COMMENTS AND APPROVAL. ONCE THE CFO, FINANCE COMMITTEE, AND THE CPA FIRM APPROVE THE FORM 990, A COPY OF THE FORM 990 IS GIVEN TO THE GOVERNING BOARD MEMBERS ALONG WITH A RESPONSE TIME FOR QUESTIONS AND COMMENTS. ALL ISSUES ARE RESOLVED AND THE FORM 990 IS FILED. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | BOARD OF DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS WILL COMPLETE A DISCLOSURE STATEMENT AT THE BEGINNING OF EACH CMH FISCAL YEAR AND PROVIDE SUCH STATEMENT TO THE CMH COMPLIANCE OFFICER. THE DISCLOSURE STATEMENT SHALL INCLUDE ANY INVESTMENT IN, OR ANY MANAGERIAL, CONSULTING, OR EMPLOYMENT RELATIONSHIP WITH, ANY OUTSIDE ENTITY THAT PROVIDES OR SEEKS TO PROVIDE GOODS OR SERVICES TO CMH, COMPETES WITH, OR INCLUDES CMH AS A JOINT VENTURE OR EQUITY INVESTOR. THE INTERESTED DIRECTOR SHOULD ABSTAIN FROM DISCUSSION AND VOTING ON THE MATTER BY TEMPORARILY LEAVING THE BOARD MEETING WHILE THE DISINTERESTED DIRECTORS DISCUSS AND VOTE. THE DISCLOSURE AND ABSTENTION SHALL BE RECORDED IN THE MINUTES OF THE BOARD MEETING. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & B | THE COMPENSATION COMMITTEE EXISTS TO DESIGN, IMPLEMENT, AND EVALUATE BONUS CRITERIA FOR THE CEO'S COMPENSATION. FURTHERMORE, THE COMPENSATION COMMITTEE COMPLETES MEDICAL STAFF CONTRACT NEGOTIATIONS, EVALUATES AND COMPARES PERSONNEL WAGES TO INDUSTRY BENCHMARKS, AND PERFORMS THE CEO AND BOARD EVALUATIONS. THE COMPENSATION COMMITTEE CONSISTS OF FOUR MEMBERS OF THE BOARD AND THE COMMITTEE MEETS AT LEAST SEMI-ANNUALLY OR MORE FREQUENTLY AS NECESSARY. THE COMPENSATION REVIEW WAS LAST CONDUCTED IN 2010. |
| AVAILABILITY OF DOCUMENTS TO THE PUBLIC | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | Prior Period Related Party Contributions $15,500 |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL CONTRACT SERVICES TOTAL FEES:2311274 |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | FORM 990 PART IX LINE 11G | DESCRIPTION:ADMINISTRATIVE CONTRACT SVCS TOTAL FEES:242402 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1 |
| City | MARYSVILLE | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320297285 | EIN |
| Primary Activities | SUPPORT | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11A | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | true | ControlledOrg |
| 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 | true | 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 | false | 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 | true | OtherTransferFromOtherOrg |