MERCY HOSPITAL JEFFERSON: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL JEFFERSON (EIN 43-0687077)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-09
- IRS object ID
- 201202229349301185
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-09T13:51:28-00:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430687077 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jefferson Memorial Hospital Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JEFF | NameControl |
| Phone | 6369331136 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 350 | AddressLine1 |
| City | Crystal City | City |
| State | MO | State |
| ZIP Code | 63019 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dan Eckenfels | Name |
| Title | CFO | Title |
| Date Signed | 2012-08-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3142315544 | Phone |
| Date Prepared | 2012-08-08 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jefferson Regional Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | James Muehlhauser | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 350 | AddressLine1 |
| City | Crystal City | City |
| State | MO | State |
| ZIP Code | 63019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 138092582 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.jhsmo.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1953 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | Jefferson Regional Medical Center is a community based integrated healthcare system. The hospital consists of a 251-bed licensed facility which provides a full range of diagnostic, preventative & healthcare services along with 24 hr emergency room care. Services are provided on a non-discriminatory basis. Jefferson Regional Medical Center is a community based integrated healthcare system. The hospital consists of a 251-bed licensed facility which provides a full range of diagnostic, preventative healthcare services along with 24 hr emergency room care. Services are provided on a non-discriminatory basis. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1600 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 77629 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -241713 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 423757 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 578787 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 130031967 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 130893395 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1058601 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1469559 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1454952 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2449029 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 132969277 | TotalRevenuePriorYear |
| Total Revenue Current Year | 135390770 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 158138 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 181815 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 64755615 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 66932861 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 159087 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 61831588 | OtherExpensePriorYear |
| Other Expenses Current Year | 66190595 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 126745341 | TotalExpensesPriorYear |
| Total Expenses Current Year | 133305271 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6223936 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2085499 | RevenuesLessExpensesCY |
| Total Assets BOY | 134837141 | TotalAssetsBOY |
| Total Assets EOY | 138256518 | TotalAssetsEOY |
| Total Liabilities BOY | 63067052 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 64150346 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 71770089 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 74106172 | NetAssetsOrFundBalancesEOY |
| Mission Description | None | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 103265723 | Expense |
| Grants | 181815 | Grants |
| Revenue | 122272911 | Revenue |
| Description | Jefferson Regional Medical Center consists of a 251-bed licensed facility which provides a wide range of services. In fiscal year 2011 the following services were provided - 12,107 admissions, 42,361 patient days, 512 deliveries, 31,667 Emergency Room visits, 2,244 inpatient surgeries including 69 open hearts, 3,910 minor and ambulatory surgery procedures and 54,433 referred outpatient procedures. It is the policy of Jefferson Regional Medical Center to provide uncompensated care to patients in need of financial assistance in accordance with the hospitals established guidelines and without regard to race, religion, sex, age or national origin. Charity and uncompensated care for the year totaled 17,982,520. Jefferson Regional Medical Center is committed to providing educational programs to the community. Free seminars and presentations are provided on a wide variety of health issues which impact patients and their families. Free services are also offered to the community such as lipid, cholesterol, bone density and glucose screenings as well as hearing and memory screenings. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5739341 | Expense |
| Revenue | 6071179 | Revenue |
| Description | Jefferson Regional Medical Center is further complimented by the Supportive Care Service Departments which provide home care services. The Home Health agency provided 20,615 visits and the Hospice agency provided 16,274 days of service for the fiscal year. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4365936 | Expense |
| Revenue | 3393380 | Revenue |
| Description | Jefferson Physician Network was added to the healthcare system in fiscal year 2009. The network employs physicians to further our services throughout the hospital and community. At the end of the fiscal year, there were 13 physicians which made up the network, which included physicians in family practice, endocrinology, rheumatology, hospitalists and wound care. The Physician Network is to expand with the recruiting of more physicians in the future. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 113371000 | 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 | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 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 | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 119 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1600 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dan Eckenfels | NamePerson |
| Telephone Number | 6369331108 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 350 | AddressLine1 |
| City | Crystal City | City |
| State | MO | State |
| ZIP Code | 63019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Dan Eckenfels | ||||||||
| CFO | 040.00 | X | 0 | 0 | 0 | |||
| James Muehlhauser | ||||||||
| President CEO | 040.00 | X | 308425 | 0 | 28528 | X | ||
| Beverly Johnson | ||||||||
| VP Patient Care Svcs | 040.00 | X | 194390 | 0 | 18239 | |||
| Blake Temple | ||||||||
| VP of Business Development | 040.00 | X | 195397 | 0 | 34699 | |||
| Jerome Ladous | ||||||||
| VP of Operations | 040.00 | X | 178959 | 0 | 23364 | |||
| Timothy Pigg | ||||||||
| VP Facilities/Support Svcs | 039.50 | X | 123520 | 0 | 31105 | |||
| Clarence Temple | ||||||||
| Physician | 040.00 | 553613 | 0 | 314 | X | |||
| William Kennen | ||||||||
| Physician | 040.00 | 542491 | 0 | 10129 | X | |||
| Lawrence Billy | ||||||||
| Physician | 040.00 | 188942 | 0 | 20031 | X | |||
| Nicole Ducharme | ||||||||
| Physician | 040.00 | 233837 | 0 | 21604 | X | |||
| Meredith Hartle | ||||||||
| Physician | 040.00 | 192469 | 0 | 5348 | X | |||
| Bill McKenna | ||||||||
| Board President | 000.50 | 0 | 0 | 0 | X | |||
| Tonda Breeze | ||||||||
| Board Vice President | 000.50 | 0 | 0 | 0 | X | |||
| Dennis Gannon | ||||||||
| Board Secretary | 000.50 | 0 | 0 | 0 | X | |||
| Ron Ravenscraft | ||||||||
| Board Treasurer | 000.50 | 0 | 0 | 0 | X | |||
| Lindell Carter | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| Martha Reed MD | ||||||||
| Board Member | 000.50 | 33365 | 0 | 0 | X | |||
| Jeff Draves MD | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| David Stansfield | ||||||||
| Board Member | 000.50 | 10600 | 0 | 0 | X | |||
| Timothy Patterson | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| Jack King | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| Benjamin Albano MD | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| Roy Burnside | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| Stoke Wischmeier | ||||||||
| Board Member | 000.50 | 0 | 0 | 0 | X | |||
| Lloyd Ford Jr | ||||||||
| CEO | 024.00 | 472322 | 0 | 28555 | X | |||
| Kenneth Kilian | ||||||||
| Board Member | 000.50 | 11100 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3239430 | TotalReportableCompFromOrg |
| Total Other Compensation | 221916 | TotalOtherCompensation |
| Number Individuals GT100 K | 26 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RehabCare Group Inc | |||||
| PO Box 502096 | St Louis | MO | 631502096 | Therapists | 1792293 |
| Sodexo Inc & Affiliates | |||||
| 4880 Paysphere Circle | Chicago | IL | 60674 | Dietary Services | 1510947 |
| Goodwin Brothers Construction Co | |||||
| 1766 Hwy 61 PO Box 110 | Crystal City | MO | 63019 | Construction | 2650726 |
| Acuity Anesthesiology LLC | |||||
| 1734 Clarkson Road Suite 147 | Chesterfield | MO | 63017 | Anesthesiologists | 3416861 |
| Brockmiller Construction Inc | |||||
| PO Box 387 | Farmington | MO | 63640 | Construction | 763368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 40 | NumberOfContractorsGT100K |
| Fundraising Events | 53792 | FundraisingEvents |
| Government Grants | 90386 | GovernmentGrants |
| All Other Contributions | 434609 | AllOtherContributions |
| Noncash Contributions | 9300 | NoncashContributions |
| Total Contributions | 578787 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|---|
| Lab Services | 621500 | 78682 | 75388 | $3,294 | |
| Net Patient Service Revenue | 621110 | 127005345 | 127005345 | ||
| Net Patient Service Revenue for physician offices | 621110 | 3809368 | 3809368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 130893395 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1161413 | TotalRevenueColumn |
| Exclusion | $1,161,413 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1091369 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1161183 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -69814 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -69814 | TotalRevenueColumn |
| Exclusion | -$69,814 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1494351 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1186205 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 308146 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 308146 | TotalRevenueColumn |
| Exclusion | $308,146 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 19826 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 53792 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 19826 | FundraisingDirectExpenses |
| Gross Income Gaming | 6425 | GrossIncomeGaming |
| Gaming Direct Expenses | 4735 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1690 | TotalRevenueColumn |
| Exclusion | $1,690 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 443777 | GrossSalesOfInventory |
| Cost Of Goods Sold | 329863 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 113914 | TotalRevenueColumn |
| Unrelated Business Revenue | 2241 | UnrelatedBusinessRevenue |
| Exclusion | $111,673 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EHR Meaningful Use-electronic med records | 519100 | 922757 | 922757 | |
| Cafe Vending | 722210 | 782471 | $782,471 | |
| Therapy Audio | 900099 | 227038 | $227,038 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 470973 | TotalRevenueColumn |
| Exclusion | $470,973 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2403239 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 135390770 | TotalRevenueColumn |
| Related Or Exempt Function Income | 131737470 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 77629 | UnrelatedBusinessRevenue |
| Exclusion | $2,996,884 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 181815 | Total |
| Program Services | 181815 | ProgramServices |
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 | 1189942 | Total |
| Program Services | 234642 | ProgramServices |
| Management And General | 955300 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1222553 | Total |
| Program Services | 954510 | ProgramServices |
| Management And General | 268043 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51882508 | Total |
| Program Services | 44513777 | ProgramServices |
| Management And General | 7261493 | ManagementAndGeneral |
| Fundraising | 107238 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1834627 | Total |
| Program Services | 1547357 | ProgramServices |
| Management And General | 287270 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6986666 | Total |
| Program Services | 5880314 | ProgramServices |
| Management And General | 1091692 | ManagementAndGeneral |
| Fundraising | 14660 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3816565 | Total |
| Program Services | 3231555 | ProgramServices |
| Management And General | 577054 | ManagementAndGeneral |
| Fundraising | 7956 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 505411 | Total |
| Program Services | 505411 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174443 | Total |
| Management And General | 174443 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55554 | Total |
| Management And General | 55554 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
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 | 13867406 | Total |
| Program Services | 10933766 | ProgramServices |
| Management And General | 2933170 | ManagementAndGeneral |
| Fundraising | 470 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1077812 | Total |
| Program Services | 19461 | ProgramServices |
| Management And General | 1057265 | ManagementAndGeneral |
| Fundraising | 1086 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24227065 | Total |
| Program Services | 23431762 | ProgramServices |
| Management And General | 790994 | ManagementAndGeneral |
| Fundraising | 4309 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 985109 | Total |
| Program Services | 14825 | ProgramServices |
| Management And General | 970284 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2573647 | Total |
| Program Services | 2308345 | ProgramServices |
| Management And General | 265302 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 498542 | Total |
| Program Services | 419102 | ProgramServices |
| Management And General | 79291 | ManagementAndGeneral |
| Fundraising | 149 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70486 | Total |
| Program Services | 59449 | ProgramServices |
| Management And General | 11037 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1873057 | Total |
| Program Services | 1579770 | ProgramServices |
| Management And General | 293287 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7439253 | Total |
| Program Services | 6294688 | ProgramServices |
| Management And General | 1144565 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 698187 | Total |
| Program Services | 159125 | ProgramServices |
| Management And General | 539062 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Recruiting | 567679 | 197901 | 369778 | |
| Minor Equipment | 137242 | 89995 | 47247 | |
| Guest Meals Special Events | 596929 | 7415 | 566295 | 23219 |
| Bad Debts | 10796562 | 10796519 | 43 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46211 | Total |
| Program Services | 9496 | ProgramServices |
| Management And General | 36715 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133305271 | Total |
| Program Services | 113371000 | ProgramServices |
| Management And General | 19775184 | ManagementAndGeneral |
| Fundraising | 159087 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18604302 | BOY |
| EOY | 22354470 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18766396 | BOY |
| EOY | 20280228 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16297211 | BOY |
| EOY | 19244341 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16379101 | BOY |
| EOY | 13431903 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2365380 | BOY |
| EOY | 3035311 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5052731 | BOY |
| EOY | 2459378 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 155132837 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 108223606 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48307156 | BOY |
| EOY | 46909231 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5359989 | BOY |
| EOY | 6584261 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3704875 | BOY |
| EOY | 3957395 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134837141 | BOY |
| EOY | 138256518 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18821319 | BOY |
| EOY | 16337301 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37635000 | BOY |
| EOY | 38514031 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6610733 | BOY |
| EOY | 9299014 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63067052 | BOY |
| EOY | 64150346 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71505065 | BOY |
| EOY | 73888345 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165024 | BOY |
| EOY | 117827 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100000 | BOY |
| EOY | 100000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71770089 | BOY |
| EOY | 74106172 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134837141 | BOY |
| EOY | 138256518 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2085499 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 250584 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Other | X | MethodOfAccountingOther |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
| Public Support Percentage509 | 0.00000 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
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) |
|---|---|---|
| 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 | $8,835 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 8835 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 25931959 | BeginningOfYearBalance |
| Contributions | 112679 | Contributions |
| Investment Earnings Or Losses | 2574333 | InvestmentEarningsOrLosses |
| End Of Year Balance | 28618971 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 22878750 | BeginningOfYearBalance |
| Contributions | 143208 | Contributions |
| Investment Earnings Or Losses | 2910001 | InvestmentEarningsOrLosses |
| End Of Year Balance | 25931959 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 22353994 | BeginningOfYearBalance |
| Contributions | 178727 | Contributions |
| Investment Earnings Or Losses | 346029 | InvestmentEarningsOrLosses |
| End Of Year Balance | 22878750 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.99000 | BoardDesignatedEOYBalance |
| Term Endowment EOY Balance | 0.01000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 316660 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 866656 | OtherCostOrOtherBasis |
| Book Value | 1183316 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 13091335 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 51942060 | OtherCostOrOtherBasis |
| Depreciation | 41867504 | Depreciation |
| Book Value | 23165891 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 633989 | OtherCostOrOtherBasis |
| Depreciation | 76554 | Depreciation |
| Book Value | 557435 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 8178800 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 73350373 | OtherCostOrOtherBasis |
| Depreciation | 62171003 | Depreciation |
| Book Value | 19358170 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1094549 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 5658415 | OtherCostOrOtherBasis |
| Depreciation | 4108545 | Depreciation |
| Book Value | 2644419 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 46909231 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Amounts due to affiliates-JPN | $7,930,926 |
| Amounts due to affiliates-ICH | $1,079,289 |
| Amounts due to affiliates-Land Co | $288,800 |
| Rounding | -$1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9299014 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| V | 4 | The endowment funds are to be used for various capital projects. |
| X | 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. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Monte Carlo Gala | NameOfEvent1 |
| Gross Receipts Event1 | 42191 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 26417 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 15774 | GrossRevenueEvent1 |
| Food And Beverage Event1 | 9229 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 6544 | EntertainmentEvent1 |
| Name Of Event2 | Golf Tournament | NameOfEvent2 |
| Gross Receipts Event2 | 30635 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 26583 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 4052 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 3750 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 302 | FoodAndBeverageEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 792 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 792 | CharitableContribOtherEvents |
| Gross Receipts Total | 73618 | GrossReceiptsTotal |
| Charitable Contributions Total | 53792 | CharitableContributionsTotal |
| Gross Revenue Total Events | 19826 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 3750 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 9531 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 6544 | EntertainmentTotalEvents |
| Direct Expense Summary Events | 19825 | DirectExpenseSummaryEvents |
| Net Income Summary | 1 | NetIncomeSummary |
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 |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3109713 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3109713 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02540 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22709274 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15988393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6720881 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05490 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25818987 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15988393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9830594 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08030 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7912 | PersonsServed |
| Total Community Benefit Expense | 13921 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13921 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 220730 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 220730 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 152716 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 152716 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7912 | PersonsServed |
| Total Community Benefit Expense | 387367 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 387367 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7912 | PersonsServed |
| Total Community Benefit Expense | 26206354 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15988393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10217961 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08340 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 35101 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 35101 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 203642 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 203642 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 238743 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 238743 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,995,808 | BadDebtExpenseAmount |
| Amount Attributable To | 2263420 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 50249597 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 54059724 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3810127 | 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 | Jefferson Regional Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 350 | AddressLine1 |
| City | Crystal City | City |
| State | MO | State |
| ZIP Code | 63019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (7 entries)
| Hospital Facility NumberHospitalFacilityNumber |
|---|
| Jefferson Memorial Hospital Psychiatric Unit |
| 1 |
| Jefferson Multi-Specialty Group |
| 2 |
| Jefferson Memorial Hospital Rehabilitation Unit |
| 3 |
| Jefferson Regional Home Care |
| 4 |
| Jefferson Regional Hospice |
| 5 |
| Jefferson Regional Outpatient Facilities LLC |
| 6 |
| Jefferson Memorial Surgical Partners LLC |
| 7 |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Jefferson Memorial Hospital Psychiatric Unit | ||||
| P O Box 350 | Crystal City | MO | 63019 | 0 |
| Jefferson Multi-Specialty Group | ||||
| 1400 Highway 61 South | Crystal City | MO | 63019 | Psychiatric services |
| Jefferson Memorial Hospital Rehabilitation Unit | ||||
| P O Box 350 | Crystal City | MO | 63019 | Outpatient physician clinic |
| Jefferson Regional Home Care | ||||
| 5 Industrial Dr | Festus | MO | 63028 | Rehabilitation services |
| Jefferson Regional Hospice | ||||
| 5 Industrial Dr | Festus | MO | 63028 | Home care services |
| Jefferson Regional Outpatient Facilities LLC | ||||
| 1400 Highway 61 South | Crystal City | MO | 63019 | Hospice services |
| Jefferson Memorial Surgical Partners LLC | ||||
| P O Box 350 | Crystal City | MO | 63019 | Urgent care services |
Form990 Schedule H Part VI Form990ScheduleHPartVI (25 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part I line 7 column f | The organization had bad debt expense in the amount of 10,796,562 reported on Part IX, line 25, however, it has been subtracted for purposes of calculating the percentage in this column. |
| Part I line 7 | The costs reported in the table in Part I, Line 7 used a ratio of patient care costs to charges computed in Worksheet 2 of the form instructions. This methodology was used for all patient segments. Part II Jefferson Regional Medical Center coordinates and/or assists patients in their transportation needs to improve access to healthcare services. Jefferson Regional recruits new physicians to serve the residents of Jefferson and surrounding counties. |
| Part III line 4 | The organization reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The organization 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 organization bills third-party payers directly and bills the patient when the patients liability is determined. Patient accounts receivable |
| Part III line 4 | 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. |
| Part III line 8 | The organizations shortfall on line 7 represents unreimbursed Medicare services provided to members of the community who might otherwise not be able to afford adequate health care services. |
| Part III line 9b | Jefferson Regional Medical Center continues to offer and process financial assistance to patients who are identified as candidates throughout the debt collection process. All collection agency letters and bills state financial assistance is available. Collection agency representatives also communicate the availability of financial assistance to patients as they recognize a financial need. They notify the Medical Center of these patients. We then follow up on these accounts and send a |
| Part III line 9b | financial assistance packet to the patient. |
| Part V | Line 19d The hospital facility uses the average rate of all payers for those services at the hospital facility. |
| Part VI Line 2 | Jefferson Regional Medical Center is currently conducting a 2-year comprehensive community health needs assessment of certain cities and towns in its primary service area. The overall goal of the assessment is to provide Jefferson Regional with the ability to clarify the health needs and priorities of the communities it serves. The project will consist of two phases. Phase I, consists of a thorough review of existing data from the Missouri Department of Public Health. The anticipated |
| Part VI Line 2 | completion of Phase I is December 2012. In Phase II, a comprehensive community survey will be distributed to a random sample of 2,400 households in our primary area. In addition, a series of community interviews will be conducted to help determine leading health needs and priorities. This is to be completed by April 2013. The final report will provide a needs assessment prepared from all the data collected in both phases of the project. |
| Part VI Line 3 | Jefferson Regional Medical Center business partner, Firstsource Solutions USA, LLC, representatives visit self-pay inpatients, patients with minimal insurance benefits and other referred patients including Emergency Department and outpatients to assist with Medicaid eligibility, SSI, W/C, TPL, Crime Victims, VA Champus, COBRA, medical hardship cases, and others. If no potential eligibility for third party payment is determined, the patient is provided with a financial assistance packet and |
| Part VI Line 3 | an explanation of the financial assistance process. Our Financial Assistance Coordinator also assists patients with any help they may need in completing required paperwork and follow up. Informational posters regarding the availability of financial assistance are displayed on every level of the facility near main entrance locations, registration areas, the Emergency Department, each individual emergency treatment room and the Patient Accounts department cashiering office. Business cards for |
| Part VI Line 3 | the Financial Assistance Coordinator are available at all registration areas and are given to potential applicants by registration personnel and during in-house visits. All medical center patient account letters and bills, as well as collection letter informing patients of the availability of financial assistance. Patient Accounts department information along with financial assistance information and applications are available on the Jefferson Regional Medical Center website. Patient Accounts |
| Part VI Line 3 | Representatives communicate the availability of financial assistance and explain eligibility criteria upon learning of patient financial need. Financial Assistance Program in-services are provided to Admitting and Social Services staff. Also, new employees are informed of the Financial Assistance Program during orientation. Financial assistance announcements/reminders are made periodically during Leadership meetings and via our Medical Center Employee Newsletter. |
| Part VI Line 4 | As one of the fastest growing counties in Missouri, Jefferson County benefits from its proximity to the amenities of St. Louis combined with the semi-rural atmosphere of small town living. Located in the Twin Cities of Crystal City and Festus, Jefferson Regional Medical Center reaches beyond the city limits to the neighboring communities of DeSoto, Herculaneum, Hillsboro and Pevely, along with many other smaller towns and villages. The hospital also serves nearby Ste. Genevieve and |
| Part VI Line 4 | St. Francois counties. Positioned near the intersection of Interstate 55 and US Highways 61 and 67, Jefferson Regional is at the primary hub for southern Jefferson County and is easily accessible from the St. Louis area as well as southeastern Missouri. According to 2010 U.S. Census data, Jefferson County as a whole grew more than 10 adding 20,634 residents for a total population of 218,733. Crystal City and Festus recorded growth percentages of 14 and 20 respectively, while other nearby |
| Part VI Line 4 | cities - with smaller base populations - grew even more dramatically including Hillsboro at 68, Pevely with 46 and Herculaneum at 24. The populations are based on Census Designated Place which does not necessarily correspond with Postal ZIP Code or municipal boundaries. Most Jefferson County residents - about 73 - live outside of the city limits in unincorporated areas of the county. Still those cities are the primary centers of commerce and community, with the majority of businesses, |
| Part VI Line 4 | churches, and schools located within the city limits. Founded as a company town around the glass factory that was built on the banks of the Mississippi River in the mid 1800s, Crystal City celebrated its centennial in 2011, marking 100 years of incorporation. Jefferson Regional owes significant gratitude to the glass factory and the community of Crystal City for the fund-raising drive that built the community hospital in 1957. The City of DeSoto is a railroad town and the largest city in |
| Part VI Line 4 | Jefferson County south of the hospital. With 6,400 residents, according to the 2010 census, it also played a significant role in the fund-raising drive that built the hospital. The City of Festus is the largest community in southern Jefferson County with a 2010 population of 11,602. In combination with the three adjacent communities of Crystal City, Herculaneum and Pevely the population within a five-mile radius of Jefferson Regional Medical Center is more than 25,000. Demographically, as |
| Part VI Line 4 | a whole, Jefferson Countys population is less than 5 non-white with very small ethnic communities located primarily in the cities of Crystal City, DeSoto and Festus. About 11 of the county population is over age 65 with the highest percentages occuring in the hospitals primary service area 17.3 in Crystal City, 13.5 in DeSoto, 13.8 in Festus, 15.4 in Herculaneum, 11 in Hillsboro and 10.8 in Pevely. The median income for the five-city base excluding Hillsboro is 46,652, while the |
| Part VI Line 4 | median income countywide is 53,939. A total of 84.6 of persons age 25 and older are high school graduates and 16.8 have a bachelors degree or higher education. |
| Part VI Line 5 | As the areas largest employer, Jefferson Regional Medical Center is committed to community building activities including collaborative efforts that focus on health education, access to care, and commercial development. The hospital hosts community residents and participates in health fair activities that bring critical healthcare information to the communities it serves. Events held on the Medical Center campus, at local businesses, and in school settings include multiple healthcare providers |
| Part VI Line 5 | offering information and screenings in a health fair format. The annual Family Health Fair held at Jefferson Regional attracts hundreds of area residents each year and provides low-cost, full-lipid panel screenings, free health assessments, and discount-priced childrens bicycle helmets. The Medical Center offers free transportation for area residents visiting the hospital for appointments. A VIP Care service coordinates the transportation and offers a lounge area for patients to wait between |
| Part VI Line 5 | appointments and tests. Patients health can be monitored during their stay in the VIP Care lounge, all at no charge. During the October 1, 2010 through September 30, 2011 reporting period, Jefferson Regional has recruited new physician specialists to serve the residents of Jefferson and surrounding counties. Jefferson Regional added a new bariatric weight loss program and now has two certified diabetic educators who serve patients and community residents. Jefferson Regional has earned |
| Part VI Line 5 | National accreditation for its Acute Rehab Program, Chest Pain Center and Stroke Center. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| City of Crystal City | |||||||
| 130 Mississippi Avenue | Crystal City | MO | 63019 | 436000936 | unit of local govt. | 10000 | general support |
| De Soto School District | |||||||
| 731 Amvets | De Soto | MO | 63020 | 436001005 | school district | 6350 | general support |
| Jefferson Reorganized School District | |||||||
| 501 Westwind Drive | Festus | MO | 63028 | 436002980 | school district | 5425 | general support |
| American Heart Association | |||||||
| 460 N Lindbergh Blvd | St Louis | MO | 63141 | 135613797 | 501c3 | 95500 | general support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 4 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | I | Identifier |
| Return Reference | 2 | ReturnReference |
| Explanation | The organization awards assistance to preapproved local charity based organizations. The amounts of 5,000 to 20,000 are approved by the CFO and amounts over 20,000 are approved by the CEO. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|
| James Muehlhauser | |||||
| 253030 | 53160 | 2235 | 12250 | 16278 | 336953 |
| Beverly Johnson | |||||
| 173317 | 17640 | 3433 | 9576 | 8663 | 212629 |
| Blake Temple | |||||
| 176925 | 17692 | 780 | 9959 | 24740 | 230096 |
| Jerome Ladous | |||||
| 161588 | 16201 | 1170 | 9036 | 14328 | 202323 |
| Timothy Pigg | |||||
| 111741 | 10999 | 780 | 6365 | 24740 | 154625 |
| Clarence Temple | |||||
| 553613 | 314 | 553927 | |||
| William Kennen | |||||
| 517491 | 25000 | 10129 | 552620 | ||
| Lawrence Billy | |||||
| 188942 | 9711 | 10320 | 208973 | ||
| Nicole Ducharme | |||||
| 194471 | 39366 | 11739 | 9864 | 255440 | |
| Meredith Hartle | |||||
| 172069 | 1650 | 18750 | 5348 | 197817 | |
| Lloyd Ford Jr | |||||
| 260093 | 62788 | 149441 | 4900 | 23655 | 500877 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | I | Identifier |
| Return Reference | 4A | ReturnReference |
| Explanation | Lloyd Ford Jr. received 147,411 in severance pay from The Jefferson Memorial Hospital Association. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| Health and Educational Facilities Authority of the State of Missouri | |||||||
| 431178966 | 60635RN45 | 2004-05-27 | 37340504 | Various capital projects | false | false | false |
| Health and Educational Facilities Authority of the State of Missouri | |||||||
| 431178966 | 60635RU47 | 2005-04-27 | 7410212 | Various capital projects | false | false | false |
| Industrial Development Authority of Jefferson County | |||||||
| 431281572 | 2010-12-16 | 3000000 | Equipment acquisition | false | false | false | |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 37275000 | TotalProceeds |
| Amount In Reserve Fund | 3571876 | AmountInReserveFund |
| Refunding Escrow | 25558528 | RefundingEscrow |
| Issuance Costs From Proceeds | 852796 | IssuanceCostsFromProceeds |
| Capital Expenditures | 6280000 | CapitalExpenditures |
| Year Of Subst Completion | 2006 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | true | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| false | false | false | false | false | true |
| false | false | false | false | false | true |
| false | false | false | false | false | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| false | false | false | false | false | false |
| false | false | false | false | false | false |
| false | false | false | false | false | false |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Clarence Temple MD | |||
| Father of B Temple-VP of Business Development | 600018 | Employed physician | false |
| Benjamin Albano Jr MD | |||
| Son of B Albano Sr-Board Member | 335570 | Employed physician | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part V | 7b | The organization supplies the information if requested by the donor. The organization will be implementing the necessary procedures to ensure notifications are provided in the future for donations. |
| Form 990 Part VI | 2 | Board members Lindell Carter and Tonda Breeze have a business relationship. |
| Form 990 Part VI | 6 | Under the Articles of Incorporation, Article VI states that the Corporation shall have one member, Jefferson Health System. |
| Form 990 Part VI | 7a | In establishing new bylaws, Jefferson Memorial Hospital Associations members of the initial board shall be reduced to nine members, as members leave the board and are not to be replaced. Once the Board of Directors are reduced to nine menbers, members shall be appointed as necessary by the sole member, Jefferson Health System, from among its 15 member Board of Directors. |
| Form 990 Part VI | 7b | Jefferson Health System, as the sole member of Jefferson Memorial Hospital Association shall maintain certain reserved powers of decisions over the sale of assets, long-term debt over a certain dollar amount, all decisions dealing with the assets and debts and any other decisions reserved for the Member. Jefferson Memorial Hospital Associations Board of Directors shall report to the Board of Directors of Jefferson Health System. |
| Form 990 Part VI | 11b | The completed tax forms 990 and its related schedules are reviewed by both the Chief Accounting Officer and the Chief Financial Officer. The final tax return is presented to the board of directors at their monthly board meeting, where they are reviewed and discussed as needed. |
| Form 990 Part VI | 12c | Jefferson Memorial Hospital Association requires all board members and senior management to complete an annual Conflict of Interest Questionnaire, which should disclose all potential and existing conflicts of interest. An annual report summarizing the comments from the questionnaire is approved by the board. As conflicts arise, members are required to disclose or abstain from voting and excuse themselves for the discussion. |
| Form 990 Part VI | 15 | Executive compensation is reviewed annually by an outside contracted individual who is responsible for bringing recommendations to the financial committee and then to the full board. This procedure establishes salary limits as well as annual strategic goals and related bonuses. |
| Form 990 Part VI | 19 | The organization makes its financial statements available to the public upon request. |
| Form 990 Part VII | 1a | The following officers also have hours recorded for related organizations - James Muehlhauser has .5 average hours per week for Jefferson Land Company, Inc and 1 average hour per week for Jefferson Health System. Dan Eckenfels has .5 average hours per week for Jefferson Land Company, Inc.. Timothy Pigg has .5 average hours per week for Jefferson Land Company, Inc.. All of the board members also have .5 average hours per week for Jefferson Land Company and Jefferson Health System. Lloyd Ford, Jr. has .5 average hours per week for both Jefferson Land Company and Jefferson Health System. |
| Form 990 Part XI | 5 | The other changes in net assets include - change in unrealized gains and losses of 633,120, change in unrestricted funds of 240,588, difference in Endowment revenue for contributions of 101,043, adjustment of prior year activity of 40,900 and rounding of 7, which totals to 250,584. |
| Form 990 Part XII | 1 | The corporation uses the modified accrual method of accounting. |
| Form 990 Part V Line 7b The organization supplies the information if requested by the donor. The organization will be implementing the necessary procedures to ensure notifications are provided in the future for donations. Form 990 Part VI Section A Line 2 Board members Lindell Carter and Tonda Breeze have a business relationship. Form 990 Part VI Section A Line 6 Under the Articles of Incorporation, Article VI states that the Corporation shall have one member, Jefferson Health System. Form 990 Part VI Section A Line 7a In establishing new bylaws, Jefferson Memorial Hospital Associations members of the initial board shall be reduced to nine members, as members leave the board and are not to be replaced. Once the Board of Directors are reduced to nine menbers, members shall be appointed as necessary by the sole member, Jefferson Health System, from among its 15 member Board of Directors. Form 990 Part VI Section A Line 7b Jefferson Health System, as the sole member of Jefferson Memorial Hospital Association shall maintain certain reserved powers of decisions over the sale of assets, long-term debt over a certain dollar amount, all decisions dealing with the assets and debts and any other decisions reserved for the Member. Jefferson Memorial Hospital Associations Board of Directors shall report to the Board of Directors of Jefferson Health System. Form 990 Part VI Section B Line 11b The completed tax forms 990 and its related schedules are reviewed by both the Chief Accounting Officer and the Chief Financial Officer. The final tax return is presented to the board of directors at their monthly board meeting, where they are reviewed and discussed as needed. Form 990 Part VI Section B Line 12c Jefferson Memorial Hospital Association requires all board members and senior management to complete an annual Conflict of Interest Questionnaire, which should disclose all potential and existing conflicts of interest. An annual report summarizing the comments from the questionnaire is approved by the board. As conflicts arise, members are required to disclose or abstain from voting and excuse themselves for the discussion. Form 990 Part VI Section B Line 15 Executive compensation is reviewed annually by an outside contracted individual who is responsible for bringing recommendations to the financial committee and then to the full board. This procedure establishes salary limits as well as annual strategic goals and related bonuses. Form 990 Part VI Section C Line 19 The organization makes its financial statements available to the public upon request. Form 990 Part VII Section A Line 1a The following officers also have hours recorded for related organizations - James Muehlhauser has .5 average hours per week for Jefferson Land Company, Inc and 1 average hour per week for Jefferson Health System. Dan Eckenfels has .5 average hours per week for Jefferson Land Company, Inc.. Timothy Pigg has .5 average hours per week for Jefferson Land Company, Inc.. All of the board members also have .5 average hours per week for Jefferson Land Company and Jefferson Health System. Lloyd Ford, Jr. has .5 average hours per week for both Jefferson Land Company and Jefferson Health System. Form 990 Part XI Line 5 The other changes in net assets include - change in unrealized gains and losses of 633,120, change in unrestricted funds of 240,588, difference in Endowment revenue for contributions of 101,043, adjustment of prior year activity of 40,900 and rounding of 7, which totals to 250,584. Form 990 Part XII Line 1 The corporation uses the modified accrual method of accounting. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | EOY AssetsEOYAssets | Direct Controlling Entity NADirectControllingEntityNA | Total IncomeTotalIncome |
|---|---|---|---|---|---|---|---|---|---|
| Jefferson Hospital Company ICH LLC | |||||||||
| 1400 Highway 61 South | Crystal City | MO | 63019 | 263754189 | Management company | MO | 142864 | N/A | |
| Jefferson Physician Network | |||||||||
| 1400 Highway 61 South | Crystal City | MO | 63019 | 263753905 | Physician offices | MO | 2609747 | N/A | 3909234 |
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| Jefferson Land Company Inc | |||||||||
| P O Box 350 | Crystal City | MO | 63019 | 431330360 | Title holding company | MO | 501c2 | N/A | false |
| Jefferson Health System | |||||||||
| 1400 Highway 61 South | Crystal City | MO | 63019 | 263920271 | Supporting organization | MO | 501c4 | N/A | false |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jefferson Memorial Surgical Partners LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 350 | AddressLine1 |
| City | Crystal City | City |
| State | MO | State |
| ZIP Code | 63019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431803975 | EIN |
| Primary Activity | Outpatient surgery | PrimaryActivity |
| Legal Domicile State | MO | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | Related | PredominantIncomeType |
| Share Of Total Income | -72422 | ShareOfTotalIncome |
| Share Of EOY Assets | 6160 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
| Percentage Ownership | 0.95690 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Apothecary Services Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 350 | AddressLine1 |
| City | Crystal City | City |
| State | MO | State |
| ZIP Code | 63019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431627267 | EIN |
| Primary Activity | Retail Pharmacy | PrimaryActivity |
| Legal Domicile State | MO | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C Corp | TypeOfEntity |
| Share Of Total Income | 749988 | ShareOfTotalIncome |
| Share Of EOY Assets | 637093 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Apothecary Services Inc | ||
| a | 29316 | actual |
| Apothecary Services Inc | ||
| r | 923569 | actual |
| Apothecary Services Inc | ||
| p | 1800000 | actual |
| Apothecary Services Inc | ||
| n | 460743 | actual |
| Apothecary Services Inc | ||
| o | 2319241 | actual |
| Jefferson Memorial Surgical Partners LLC | ||
| r | 579565 | book value of assets |
| Jefferson Health System | ||
| n | 885549 | actual |
| Jefferson Health System | ||
| p | 1125000 | actual |
| Jefferson Health System | ||
| a | 41500 | actual |
| Jefferson Health System | ||
| o | 172161 | actual |
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