GOODALL WITCHER HEALTHCARE FOUNDATION INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- GOODALL WITCHER HEALTHCARE FOUNDATION INC (EIN 74-1546619)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-07
- IRS object ID
- 201341279349301614
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-07T16:00:07-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | 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 | 7901 Woodway Drive Suite 100 | AddressLine1 |
| City | Waco | City |
| State | TX | State |
| ZIP Code | 76712 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 741546619 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOODALL-WITCHER HEALTH CARE FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % CLARENCE FIELDS JR | InCareOfName |
| Name Control | GOOD | NameControl |
| Phone | 2546758322 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 549 | AddressLine1 |
| City | CLIFTON | City |
| State | TX | State |
| ZIP Code | 76634 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ADAM B WILLMANN | Name |
| Title | CEO | Title |
| Phone | 2546758322 | Phone |
| Date Signed | 2013-02-21 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Amanda Maya | Name |
| Phone | 2547768244 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CLARENCE FIELDS JR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 549 | AddressLine1 |
| City | CLIFTON | City |
| State | TX | State |
| ZIP Code | 76634 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 18046045 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GWHF.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1966 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE ACCESS TO AND DELIVERY OF QUALITY HEALTHCARE SERVICES THROUGH EFFICIENT, COMPREHENSIVE, AND FRIENDLY CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 274 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 464811 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 162961 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20116287 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17423914 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 13622 | InvestmentIncomePriorYear |
| Investment Income Current Year | 11633 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 232719 | OtherRevenuePriorYear |
| Other Revenue Current Year | 447537 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20827439 | TotalRevenuePriorYear |
| Total Revenue Current Year | 18046045 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9131121 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8330356 | 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 | 10374124 | OtherExpensePriorYear |
| Other Expenses Current Year | 10481670 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19505245 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18812026 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1322194 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -765981 | RevenuesLessExpensesCY |
| Total Assets BOY | 16800355 | TotalAssetsBOY |
| Total Assets EOY | 17110638 | TotalAssetsEOY |
| Total Liabilities BOY | 9777820 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10857102 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7022535 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6253536 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE ACCESS TO AND DELIVERY OF QUALITY HEALTHCARE SERVICES THROUGH EFFICIENT, COMPREHENSIVE, AND FRIENDLY CARE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 16817663 | Expense |
| Revenue | 17732164 | Revenue |
| Description | PROVIDED HEALTHCARE SERVICES THROUGH THE OPERATION OF A HOSPITAL, AN OUTPATIENT CLIENT, A HOME HEALTH AGENCY, A NURSING FACILITY AND A WELLNESS AND FITNESS CENTER. PATIENT DAYS TOTALED 4085; 373 OPERATIONS WERE PERFORMED, 99,829 TESTING PROCEDURES COMPLETED, AND 566 PHYSICIAL/OCCUPATIONAL SPEECH THERAPY VISITS OCCURRED. EMERGENCY ROOM VISITS TOTALED 4594. THE FOUNDATION ALSO PROVIDED CHARITY CARE IN THE AMOUNT OF $2,064,483. | Description |
| Total Program Service Expense | 16817663 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | 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 | false | 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 | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | 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 | 273 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 274 | 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | 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 | 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 | false | 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 | CLARENCE FIELDS JR | NamePerson |
| Telephone Number | 2546758322 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 S AVENUE T | AddressLine1 |
| City | CLIFTON | City |
| State | TX | State |
| ZIP Code | 76634 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 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 |
|---|---|---|---|---|---|---|---|
| RICHARD LUNDBERG | |||||||
| CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | |
| TOM HENDERSON | |||||||
| VICE CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | |
| CHARLENE W PARKS | |||||||
| SECRETARY | 1.0 | X | X | 0 | 0 | 0 | |
| ALAN MICHAEL DAY | |||||||
| TREASURER | 1.0 | X | X | 0 | 0 | 0 | |
| DARLENE MUNDEN | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| JOHN GILLIAM | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| BRUCE BERG | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| CLARENCE FIELDS JR | |||||||
| PRESIDENT/CEO | 40.0 | X | 123660 | 0 | 3710 | ||
| VICKI GLOFF | |||||||
| CFO | 40.0 | X | 68634 | 2644 | |||
| DAVID ZSCHIESCHE | |||||||
| PHARMACIST | 40.0 | 108134 | 0 | 5728 | X | ||
| MARY WERLINGER | |||||||
| NURSE PRACTITIONER | 40.0 | 98777 | 0 | 5499 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 399205 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 17581 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CLIFTON PHYSICIANS PA | |||||
| 101 S AVENUE T | CLIFTON | TX | 76634 | PHYSICIAN GROUP | 1889786 |
| BRAZOS STAFFING NETOWRK | |||||
| 101 S AVENUE T | CLIFTON | TX | 76634 | ER COVERAGE | 658000 |
| NORTH HILL COUNTRY ANESTHESIA | |||||
| P O BOX 93 | CRANFILLS GAP | TX | 76637 | CRNA COVERAGE | 308051 |
| BKD LLP | |||||
| 14241 DALLAS PKWY STE 1100 | DALLAS | TX | 75254 | ACCOUNTING SERVICES | 132767 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 8387 | GovernmentGrants |
| All Other Contributions | 154574 | AllOtherContributions |
| Total Contributions | 162961 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| HOSPITAL OPERATIONS | 621110 | 17404814 | 17404814 |
| CLINIC RENT | 531120 | 19100 | 19100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17423914 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11633 | TotalRevenueColumn |
| Exclusion | $11,633 | 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 |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EHR INCENTIVE REVENUE | 900099 | 308250 | 308250 | |
| MISCELLANEOUS REVENUE | 900099 | 110940 | $110,940 | |
| CAFETERIA SALES | 722100 | 23983 | $23,983 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4364 | TotalRevenueColumn |
| Exclusion | $4,364 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 447537 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18046045 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17732164 | RelatedOrExemptFunctionIncome |
| Exclusion | $150,920 | 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 | 207402 | Total |
| Management And General | 207402 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
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 | 7407284 | Total |
| Program Services | 6443142 | ProgramServices |
| Management And General | 964142 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71693 | Total |
| Program Services | 60939 | ProgramServices |
| Management And General | 10754 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54859 | Total |
| Program Services | 46627 | ProgramServices |
| Management And General | 8232 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 589118 | Total |
| Program Services | 459413 | ProgramServices |
| Management And General | 129705 | 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 | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 3692394 | Total |
| Program Services | 3503584 | ProgramServices |
| Management And General | 188810 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30234 | Total |
| Program Services | 1913 | ProgramServices |
| Management And General | 28321 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109267 | Total |
| Program Services | 56228 | ProgramServices |
| Management And General | 53039 | 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 | 618084 | Total |
| Program Services | 585614 | ProgramServices |
| Management And General | 32470 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28254 | Total |
| Program Services | 23490 | ProgramServices |
| Management And General | 4764 | 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 | 18020 | Total |
| Program Services | 12376 | ProgramServices |
| Management And General | 5644 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 346230 | Total |
| Program Services | 346230 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1084417 | Total |
| Program Services | 1084417 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 812314 | Total |
| Program Services | 600189 | ProgramServices |
| Management And General | 212125 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 2150515 | 2150515 | |
| MEDICAL SUPPLIES | 1428078 | 1428078 | |
| MISC EXPENSES | 131543 | 131543 | |
| LICENSE AND PERMITS | 32320 | 14908 | 17412 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18812026 | Total |
| Program Services | 16817663 | ProgramServices |
| Management And General | 1994363 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 541581 | BOY |
| EOY | 787360 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 842782 | BOY |
| EOY | 969650 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48138 | BOY |
| EOY | 24313 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3275514 | BOY |
| EOY | 3103098 | 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 | 167414 | BOY |
| EOY | 175363 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14018 | BOY |
| EOY | 83241 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 22754885 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 11946300 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10749811 | BOY |
| EOY | 10808585 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 511225 | BOY |
| EOY | 475060 | 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 | 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 | 649872 | BOY |
| EOY | 683968 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16800355 | BOY |
| EOY | 17110638 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1550016 | BOY |
| EOY | 2816886 | 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 | 8227804 | BOY |
| EOY | 8040216 | 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 | 9777820 | BOY |
| EOY | 10857102 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7022535 | BOY |
| EOY | 6253536 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 7022535 | BOY |
| EOY | 6253536 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16800355 | BOY |
| EOY | 17110638 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -765981 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -3018 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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 | |
| 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 | $3,477 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 3477 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER ACTIVITY | Identifier |
| Return Reference | PART II-B, LINE 1F | ReturnReference |
| Explanation | HOSPITAL PAID DUES TO ORANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING TORCH DUES $2,750 10% $275 THA DUES $6,829 24% $1,639 AHA DUES $6,512 24% $1,563 TOTAL $16,091 $3,477 | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 318041 | OtherCostOrOtherBasis |
| Book Value | 318041 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13427423 | OtherCostOrOtherBasis |
| Depreciation | 3988188 | Depreciation |
| Book Value | 9439235 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7412584 | OtherCostOrOtherBasis |
| Depreciation | 7352486 | Depreciation |
| Book Value | 60098 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1596837 | OtherCostOrOtherBasis |
| Depreciation | 605626 | Depreciation |
| Book Value | 991211 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10808585 | TotalOfBookValueLandBuildings |
| Total Revenue | 18046045 | TotalRevenue |
| Total Expenses | 18812026 | TotalExpenses |
| Excess Or Deficit For Year | -765981 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -3018 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -3018 | TotalAdjustments |
| Excess Or Deficit Per FS | -768999 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 18043027 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -3018 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -3018 | RevenueNotRptdF990 |
| Revenue Subtotal | 18046045 | RevenueSubtotal |
| Total Revenue Per Form990 | 18046045 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 18812026 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 18812026 | ExpensesSubtotal |
| Total Expenses Per Form990 | 18812026 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| 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 | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1006944 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1006944 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06040 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1250414 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 808590 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 441824 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02650 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 153278 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 123012 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 30266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2410636 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 931602 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1479034 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08870 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 52508 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 52508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 64209 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 64209 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 445024 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 445024 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02670 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 561741 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 561741 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03380 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2972377 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 931602 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2040775 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12250 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,150,515 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5221783 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3336820 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1884963 | 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 | GOODALL-WITCHER HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 S AVENUE T | AddressLine1 |
| City | CLIFTON | City |
| State | TX | State |
| ZIP Code | 76634 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| 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 | GOODALL-WITCHER HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | false | AllNeedsAddressed |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| 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 | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CLIFTON MEDICAL CLINIC | ||||
| 201 S AVENUE T | CLIFTON | TX | 76634 | RURAL HEALTH CLINIC |
| GOODALL-WITCHER HOME HEALTH AGENCY | ||||
| 300 HILLSIDE DRIVE | CLIFTON | TX | 76634 | HOME HEALTH AGENCY |
| GOODALL-WITCHER NURSING FACILITY | ||||
| 101 S AVENUE T | CLIFTON | TX | 76634 | LONG TERM CARE NURSING FACILIT |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CHARITY CARE ELIGIBILITY CRITERIA | SCHEDULE H, PART I, LINE 3C | PATIENTS WITHOUT INSURANCE ARE ELIGIBLE FOR A 15% DISCOUNT OF TOTAL CHARGES WHEN THE BALANCE IS PAID IN FULL WITHIN THIRTY DAYS. |
| BAD DEBT EXPENSE EXCLUDED IN CALCULATION OF PATIENT CARE COST TO CHARGES | SCHEDULE H, PART I, LINE 7 COLUMN F | BAD DEBT EXPENSE IN THE AMOUNT OF $2,150,515 WAS INCLUDED ON FORM 990, PART IV, LINE 25 IN TOTAL EXPENSES. HOWEVER, THIS AMOUNT WAS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF PATIENT CARE COST TO CHARGES. |
| BAD DEBT EXPENSE | SCHEDULE H, PART III, SECTION A, LINE 4 | THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNT RECEIVABLES 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 AMOUNT ON LINE 2 IS THE BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. |
| COSTING METHODOLOGY | SCHEDULE H, PART III, SECTION B, LINE 8 | THE MEDICAL CENTER USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. |
| COLLECTION POLICY | SCHEDULE H, PART III, SECTION B, LINE 9B | THE ORGANIZATIONS COLLECTION POLICY STATES THAT NO COLLECTION EFFORTS WILL BE PURSUED ON A CHARITY ACCOUNT AFTER SUCH A DETERMINATION IS MADE. |
| INPUT FROM THE COMMUNITY FOR NEEDS ASSESSMENT | SCHEDULE H, PART V, SECTION B, LINE 3 | COMMUNITY WAS REPRESENTED BY NURSING FACILITY ADMINISTRATION, TEXAS REGION 7 PUBLIC HEALTH NURSE, BUSINESSES IN THE COMMUNITY, CHAMBER OF COMMERCE, MINISTERIAL ALLIANCE, CHAIRMAN OF HOSPITAL BOARD AND PRESIDENT OF THE CLIFTON PHYSICIANS GROUP. |
| NEEDS NOT ADDRESSED FROM NEEDS ASSESSMENT | SCHEDULE H, PART V, SECTION B, LINE 7 | SOME NEEDS WERE NOT ADDRESSED DUE TO BUDGET CONSTRAINTS. MENTAL HEALTH ISSUES WERE NOT ADDRESSED DUE TO STAFFING SHORTAGES. |
| SCHEDULE H, PART V, SECTION B, LINE 15, 16 & 17 | NEITHER GOODALL-WITCHER HEALTH CARE FOUNDATION, NOR THIRD PARTIES AUTHORIZED BY THE GOODALL-WITCHER HEALTH CARE FOUNDATION, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. | |
| DETERMINATION OF AMOUNTS BILLED FOR EMERGENCY CARE | SCHEDULE H, PART V, SECTION B, LINE 19 | PATIENTS WITHOUT INSURANCE ARE ELIGIBLE FOR A 15% DISCOUNT OF TOTAL CHARGES WHEN THE BALANCE IS PAID IN FULL WITHIN THIRTY DAYS. ELIGIBILTY FOR FREE CARE IS DETERMINED BASED UPON 200% OF FEDERAL POVERTY GUIDELINES. |
| NEEDS ASSESSMENT | SCHEDULE H, PART VI, LINE 2 | PERIODIC INPUT FROM THE COMMUNITY IS GATHERED TO IDENTIFY NEEDS. PHYSICIAN RECRUITMENT ATTEMPTS TO ADDRESS COMMUNITY NEEDS WITH HOSPITAL SERVICES. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | ANNUAL CHARITY AMOUNTS ARE POSTED IN THE LOCAL NEWSPAPER. EACH PATIENT IS GIVEN AN APPLICATION FOR CHARITY CARE UPON ADMISSION. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4 | THE HOSPITAL SERVES THE RURAL AREAS OF BOSQUE COUNTY AND SOME PORTIONS OF CONTIGUOUS COUNTIES. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5 | THE HOSPITAL PROVIDES MEDICAL ASSISTANCE SERVICES FOR QUALIFYING INDIVIDUALS. A LICENSED DIETICIAN IS ALSO MADE AVAILABLE FOR COUNSELING. THE HOSPITAL ALSO HAS HOSTED MCLENNAN COMMUNITY COLLEGE LVN SCHOOL STUDENTS AS WELL. THE HOSPITAL PARTICIPATED IN RELAY FOR LIFE, SAY NO TO DRUGS SCHOOL INITIATIVE, TRICK OR TREAT MAIN STREET, JUNIOR AND HIGH SCHOOL VOLUNTEER PROGRAMS AND CAREER WEEKS, ALONG WITH MONTHLY HOSTING OF THE MINISTERIAL ALLIANCE. THE HOSPITAL HAS AN OPEN MEDICAL STAFF AND ALL MEMBERS OF THE BOARD OF DIRECTORS RESIDE IN THE COMMUNITY SERVED BY THE HOSPITAL. |
| AFFILIATED HEALTH CARE SYSTEM | SCHEDULE H, PART VI, LINE 6 | N/A |
| STATE FILING OF COMMUNITY BENEFIT REPORT | SCHEDULE H, PART VI, LINE 7 | TEXAS |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCESS TO REVIEW THE FORM 990 | FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM FOLLOWING THE COMPLETION OF AN AUDIT OF FINANCIAL STATEMENTS. THE CEO REVIEWS THE RETURN PRIOR TO FILING. |
| PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT ANNUALLY. |
| REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION | FORM 990, PART VI, SECTION B, LINE 15A | TEXAS ORGANIZATION OF RURAL & COMMUNITY HOSPITAL SALARY SURVEY IS USED IN REVIEWING CEO SALARY. THE FINANCIAL CONDITION OF THE FACILITY IS ALSO A CONSIDERATION IN DETERMINING ANY COMPENSATION INCREASES. CEO SALARY REVIEWED BY GOVERNING BOARD DEC 2011. |
| REVIEW OF OTHER OFFICER OR KEY EMPLOYEES COMPENSATION | FORM 990, PART VI, SECTION B, LINE 15B | CEO REVIEWED CFO COMPENSATION IN 2011. |
| OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE | FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATIONAL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| OTHER ADJUSTMENT | FORM 990, PART XI, LINE 5 | UNREALIZED GAIN -$3,018 --------------------------- TOTAL -$3,018 |