MARGARET MARY COMMUNITY HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MARGARET MARY COMMUNITY HOSPITAL INC (EIN 35-6067049)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-02
- IRS object ID
- 201223079349300027
- Schema version
- 2011v1.2
- 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 O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-02T11:51:02-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351178661 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE AMERICAN SQUARE 2200 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 356067049 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARGARET MARY COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MARG | NameControl |
| Phone | 8129346624 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MITCHELL AVENUE | AddressLine1 |
| City | BATESVILLE | City |
| State | IN | State |
| ZIP Code | 470068913 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN DAEGER | Name |
| Title | VP OF FINANCE | Title |
| Phone | 8129346624 | Phone |
| Date Signed | 2012-11-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEISHA CORSO CPA | Name |
| PTIN | P00852354 | PTIN |
| Phone | 3176334705 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRIAN DAEGER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MITCHELL AVENUE | AddressLine1 |
| City | BATESVILLE | City |
| State | IN | State |
| ZIP Code | 470068913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 89072898 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MMCH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 596 | TotalNbrEmployees |
| Total Nbr Volunteers | 57 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 194886 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 480972 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 62638938 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 71736916 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -402511 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1193195 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 705770 | OtherRevenuePriorYear |
| Other Revenue Current Year | 608935 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 63137083 | TotalRevenuePriorYear |
| Total Revenue Current Year | 74020018 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 89257 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 38000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30302767 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 33499846 | 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 | 28931182 | OtherExpensePriorYear |
| Other Expenses Current Year | 33330144 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 59323206 | TotalExpensesPriorYear |
| Total Expenses Current Year | 66867990 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3813877 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7152028 | RevenuesLessExpensesCY |
| Total Assets BOY | 106910562 | TotalAssetsBOY |
| Total Assets EOY | 111889864 | TotalAssetsEOY |
| Total Liabilities BOY | 43096876 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 44747545 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 63813686 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 67142319 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1461928 | Expense |
| Grants | 0 | Grants |
| Revenue | 97288 | Revenue |
| Description | COMMUNITY HEALTH SERVICES-OVER 77,397 INDIVIDUALS TOOK PART IN SERVICES AND PROGRAMS SUCH AS CANCER SCREENINGS, CPR AND AED TRAINING, DIABETES CARE, FLU CLINICS, NUTRITION CLASSES, SMOKING CESSATION SUPPORT, BLOOD PRESSURE AND THYROID SCREENINGS, WOMEN'S HEALTH EVENTS, OSTEOPOROSIS SCREENINGS, WELLNESS SCREENINGS, EMERGENCY PREPAREDNESS, AND HEALTH INSURANCE ENROLLMENT AND REFERRALS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 349258 | Expense |
| Grants | 0 | Grants |
| Revenue | 0 | Revenue |
| Description | SUBSIDIZED HEALTH SERVICES - 7,518 INDIVIDUALS RECEIVED BENEFITS FROM OUR HOSPITAL OWNED PHYSICIAN PRACTICE IN OSGOOD. THIS PRIMARY CARE PRACTICE IS LOCATED IN A RURAL AREA AND IS ALSO LOCATED IN A MEDICALLY UNDERSERVED AREA. 639 INDIVIDUALS RECEIVED BENEFITS FROM OUR EMERGENCY AND TRAUMA SERVICES (CHEST PAIN AND TELESTROKE). | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 251552 | Expense |
| Grants | 0 | Grants |
| Revenue | 7585 | Revenue |
| Description | FINANCIAL AND IN-KIND CONTRIBUTIONS - 3,957 INDIVIDUALS HAVE RECEIVED BENEFITS FROM OUR EMS AND PARAMEDIC TRAINING AND SUBSIDY PROGRAMS. MMCH SUBSIDIZES A PORTION OF THE RIPLEY COUNTY PARAMEDIC/EMS DIRECTOR'S SALARY. MMCH ALSO COORDINATES AND SUBSIDIZES TRAINING FOR THE 4 RIPLEY COUNTY SQUADS LOCATED IN VERSAILLES, SUNMAN, MILAN, AND BATESVILLE. IN ADDITION, VARIOUS MMCH TEAM MEMBERS SERVE ON NUMEROUS COMMUNITY BOARDS INCLUDING MARCH OF DIMES, RELAY FOR LIFE, AND THE BATESVILLE COORDINATED SCHOOL HEALTH BOARD. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 56529955 | Expense |
| Grants | 38000 | Grants |
| Revenue | 71775200 | Revenue |
| Description | OVER 7,000 INDIVIDUALS HAVE TAKEN PART IN ADDITIONAL PROGRAMS AND SERVICES PROVIDED BY MMCH, INCLUDING CAREER AND WORKFORCE DEVELOPMENT FOR PHYSICIAN, NURSING, AND OTHER MEDICAL STUDENTS THROUGH OUR MENTORING PROGRAMS AND CAREER FAIRS. IN ADDITION, MMCH IS INVOLVED IN CLINICAL RESEARCH AT THE HANSEN CENTER, A CANCER TREATMENT CENTER OWNED AND OPERATED BY MMCH IN BATESVILLE. VARIOUS COMMUNITY NEEDS/HEALTH ASSESSMENTS ALSO TAKE PLACE ON A CONTINUOUS BASIS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 56529955 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 38000 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 71775200 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 58592693 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 101 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 596 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOM WALKER ACCOUNTING MANAGER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8129346624 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MITCHELL AVENUE | AddressLine1 |
| City | BATESVILLE | City |
| State | IN | State |
| ZIP Code | 470060226 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 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 |
|---|---|---|---|---|---|---|---|
| TIMOTHY PUTNAM | |||||||
| PRESIDENT | 40.00 | X | X | 258516 | 0 | 38726 | |
| JOHN DICKEY | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MARK GIESTING | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JEFFREY HATCHER MD | |||||||
| MEMBER | 40.00 | X | 432932 | 0 | 58307 | ||
| GEORGE JUNKER | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| DONALD KARBOWSKI | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| RONALD KNUEVEN | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| CINDY LAUBER | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JIM ROBERTS | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| SAM ROW | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JAN SANTERRE | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| CHRIS TRAINOR | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MARY ANN WISE-CASTNER | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| STEVE YOUNGMAN | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| BRIAN DAEGER | |||||||
| VP FINANCE | 40.00 | X | 190320 | 0 | 34095 | ||
| JULIE KEENE | |||||||
| VP OF PHYSICIAN SERVICES | 40.00 | X | 128076 | 0 | 32247 | ||
| BONNIE PLOEGER | |||||||
| VP INPATIENT SERVICES | 40.00 | X | 125286 | 0 | 21721 | ||
| NANCY MARTICKE | |||||||
| VP OUTPATIENT SERVICES | 40.00 | X | 190141 | 0 | 36211 | ||
| KIM INSCHO | |||||||
| VP HUMAN RESOURCES | 40.00 | X | 160584 | 0 | 33933 | ||
| THOMAS BROWN MD | |||||||
| PHYSICIAN | 40.00 | 375365 | 0 | 39107 | X | ||
| BRIAN ALBERS MD | |||||||
| PHYSICIAN | 40.00 | 372869 | 0 | 59260 | X | ||
| JON GEERS MD | |||||||
| PHYSICIAN | 40.00 | 342588 | 0 | 30184 | X | ||
| KIMBERLY KICK MD | |||||||
| PHYSICIAN | 40.00 | 230729 | 0 | 36792 | X | ||
| THOMAS DECILLES MD | |||||||
| PHYSICIAN | 40.00 | 207847 | 0 | 34131 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3015253 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 454714 | TotalOtherCompensation |
| Number Individuals GT100 K | 27 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PREFERRED EMERGENCY SPECIALISTS INC | |||||
| 235 INDUSTRIAL DR | FRANKLIN | OH | 45005 | EMERGENCY ROOM PHYSICIAN STAFFING SERVIC | 813396 |
| MIDWEST EMERGENCY DEPT SERVICES | |||||
| 320 EAST HIGHWAY 50 | OFALLON | IL | 62269 | EMERGENCY ROOM PHYSICIAN STAFFING SERVIC | 772945 |
| SOUTH BEND MEDICAL FOUNDATION | |||||
| 530 N LAFAYETTE BLVD | SOUTH BEND | IN | 46601 | LAB SERVICES | 269786 |
| HOOSIER ENTERPRISES | |||||
| 9455 DELEGATES ROW | INDIANAPOLIS | IN | 46240 | HOSPICE SERVICES | 250234 |
| BLUE & CO | |||||
| ONE AMERICAN SQUARE 2200 | INDIANAPOLIS | IN | 46282 | CPA FIRM | 204095 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| Fundraising Events | 21490 | FundraisingEvents |
| Government Grants | 260000 | GovernmentGrants |
| All Other Contributions | 199482 | AllOtherContributions |
| Total Contributions | 480972 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621110 | 126348387 | 126348387 |
| CHARITY CARE | 621110 | -1855734 | -1855734 |
| CONTRACTUAL ALLOWANCES | 621110 | -52755737 | -52755737 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 71736916 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 888463 | TotalRevenueColumn |
| Exclusion | $888,463 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 143157 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 143157 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143157 | TotalRevenueColumn |
| Related Or Exempt Function Income | 143157 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 15332248 | Securities |
| Other | 11069 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 15028567 | Securities |
| Other | 10018 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 303681 | Securities |
| Other | 1051 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 304732 | TotalRevenueColumn |
| Exclusion | $304,732 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 6165 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 21490 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 14295 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -8130 | TotalRevenueColumn |
| Exclusion | -$8,130 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS | 900099 | 271627 | $271,627 |
| CAFETERIA | 900099 | 197825 | $197,825 |
| VENDING | 900099 | 4456 | $4,456 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 473908 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 74020018 | TotalRevenueColumn |
| Related Or Exempt Function Income | 71880073 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,658,973 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38000 | Total |
| Program Services | 38000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1744037 | Total |
| Program Services | 1528202 | ProgramServices |
| Management And General | 215835 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23608701 | Total |
| Program Services | 20686989 | ProgramServices |
| Management And General | 2921712 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 661899 | Total |
| Program Services | 579985 | ProgramServices |
| Management And General | 81914 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5743192 | Total |
| Program Services | 5032439 | ProgramServices |
| Management And General | 710753 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1742017 | Total |
| Program Services | 1526432 | ProgramServices |
| Management And General | 215585 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8279691 | Total |
| Program Services | 7255032 | ProgramServices |
| Management And General | 1024659 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 157710 | Total |
| Program Services | 138192 | ProgramServices |
| Management And General | 19518 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9067767 | Total |
| Program Services | 7945579 | ProgramServices |
| Management And General | 1122188 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1337424 | Total |
| Program Services | 1171910 | ProgramServices |
| Management And General | 165514 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 267231 | Total |
| Program Services | 234160 | ProgramServices |
| Management And General | 33071 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174384 | Total |
| Program Services | 152803 | ProgramServices |
| Management And General | 21581 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1443156 | Total |
| Program Services | 1264557 | ProgramServices |
| Management And General | 178599 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4999428 | Total |
| Program Services | 4380720 | ProgramServices |
| Management And General | 618708 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 592709 | Total |
| Program Services | 519358 | ProgramServices |
| Management And General | 73351 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 6324882 | 5542142 | 782740 |
| OTHER EXP | 445194 | 385397 | 59797 |
| DUES & SUB. | 240568 | 210796 | 29772 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66867990 | Total |
| Program Services | 58592693 | ProgramServices |
| Management And General | 8275297 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13234945 | BOY |
| EOY | 13845347 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7270089 | BOY |
| EOY | 7086953 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 865276 | BOY |
| EOY | 948755 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 468904 | BOY |
| EOY | 616076 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 106319471 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 54989189 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49956584 | BOY |
| EOY | 51330282 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34269423 | BOY |
| EOY | 36228694 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 845341 | BOY |
| EOY | 1833757 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106910562 | BOY |
| EOY | 111889864 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4800177 | BOY |
| EOY | 6216701 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34925235 | BOY |
| EOY | 33782073 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3371464 | BOY |
| EOY | 4748771 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43096876 | BOY |
| EOY | 44747545 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63665762 | BOY |
| EOY | 67047592 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147924 | BOY |
| EOY | 94727 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63813686 | BOY |
| EOY | 67142319 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106910562 | BOY |
| EOY | 111889864 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 7152028 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -3823395 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | 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) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $4,678 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4678 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | PORTION OF ANNUAL DUES PAID TO TRADE ASSOCIATIONS ALLOCATED TO LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 44740699 | BeginningOfYearBalance |
| Contributions | 3183091 | Contributions |
| Investment Earnings Or Losses | -1255562 | InvestmentEarningsOrLosses |
| Other Expenditures | 3770057 | OtherExpenditures |
| End Of Year Balance | 42898171 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 28745024 | BeginningOfYearBalance |
| Contributions | 12087147 | Contributions |
| Investment Earnings Or Losses | 3997487 | InvestmentEarningsOrLosses |
| Other Expenditures | 35690 | OtherExpenditures |
| Administrative Expenses | 53269 | AdministrativeExpenses |
| End Of Year Balance | 44740699 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 28185363 | BeginningOfYearBalance |
| Contributions | 79491 | Contributions |
| Investment Earnings Or Losses | 585756 | InvestmentEarningsOrLosses |
| Other Expenditures | 105586 | OtherExpenditures |
| End Of Year Balance | 28745024 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 21243317 | BeginningOfYearBalance |
| Contributions | 63435 | Contributions |
| Investment Earnings Or Losses | 6993987 | InvestmentEarningsOrLosses |
| Other Expenditures | 115376 | OtherExpenditures |
| End Of Year Balance | 28185363 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.99780 | BoardDesignatedEOYBalance |
| Term Endowment EOY Balance | 0.00220 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2371158 | OtherCostOrOtherBasis |
| Book Value | 2371158 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 62109016 | OtherCostOrOtherBasis |
| Depreciation | 27274259 | Depreciation |
| Book Value | 34834757 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37800680 | OtherCostOrOtherBasis |
| Depreciation | 27714930 | Depreciation |
| Book Value | 10085750 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4038617 | OtherCostOrOtherBasis |
| Book Value | 4038617 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 51330282 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DERIVATIVE LIABILITY | $3,364,601 |
| ESTIMATED THIRD-PARTY SETTLEMENT | $1,384,170 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4748771 | TotalOfAmounts |
| Total Revenue | 74020018 | TotalRevenue |
| Total Expenses | 66867990 | TotalExpenses |
| Excess Or Deficit For Year | 7152028 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -3823395 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -3823395 | TotalAdjustments |
| Excess Or Deficit Per FS | 3328633 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 70196623 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -2308297 | NetUnrealizedGainsInvestments |
| Other Revenues | -1515098 | OtherRevenues |
| Revenue Not Rptd F990 | -3823395 | RevenueNotRptdF990 |
| Revenue Subtotal | 74020018 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 74020018 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 66867990 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 66867990 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 66867990 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ASSETS WHOSE USE IS LIMITED ARE ASSETS WHOSE USE IS LIMITED BY INTERNAL BOARD DESIGNATION INCLUDING CASH AND CASH EQUIVALENTS, ACCRUED INTEREST RECEIVABLE, AND MARKET SECURITIES WHICH ARE BEING USED FOR CAPITAL IMPROVEMENTS, RETIREMENT PLAN, AND FOR DEBT SERVICE PAYMENTS. TEMPORARILY RESTRICTED NET ASSESTS ARE THE FUNDS WHOSE USE HAS BEEN LIMITED BY EXTERANAL SOURCES FOR A SPECIFIC TIME PERIOD OR PURPOSE WHICH ARE BEING USED FOR SCHOLARSHIPS AND OTHER HOSPITAL PROGRAMS. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 SUPERSEDED BY FASB ACCOUNTING STANDARD CODIFICATION 740-10: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2011 AND 2010, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | UNREALIZED LOSS ON DERIVATIVES -1,515,098. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF EVENT | NameOfEvent1 |
| Gross Receipts Event1 | 17980 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 13827 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 4153 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 5574 | NonCashPrizesEvent1 |
| Food And Beverage Event1 | 4986 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 3735 | OtherDirectExpensesEvent1 |
| Name Of Event2 | HOSPICE FUN RUN | NameOfEvent2 |
| Gross Receipts Event2 | 9675 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 7663 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 2012 | GrossRevenueEvent2 |
| Gross Receipts Total | 27655 | GrossReceiptsTotal |
| Charitable Contributions Total | 21490 | CharitableContributionsTotal |
| Gross Revenue Total Events | 6165 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 5574 | NonCashPrizesTotalEvents |
| Food And Beverage Total Events | 4986 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 3735 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 14295 | DirectExpenseSummaryEvents |
| Net Income Summary | -8130 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 275.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 275.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1748 | PersonsServed |
| Total Community Benefit Expense | 784975 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 784975 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01300 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3171845 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 726336 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2445509 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04040 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1748 | PersonsServed |
| Total Community Benefit Expense | 3956820 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 726336 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3230484 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05340 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 47 | NumberOfActivitiesOrPrograms |
| Persons Served | 78579 | PersonsServed |
| Total Community Benefit Expense | 1723420 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 102313 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1621107 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02680 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 3958 | PersonsServed |
| Total Community Benefit Expense | 538986 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10814 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 528172 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00870 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 8157 | PersonsServed |
| Total Community Benefit Expense | 349258 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 349258 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 502 | PersonsServed |
| Total Community Benefit Expense | 86486 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 86486 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 3957 | PersonsServed |
| Total Community Benefit Expense | 251552 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7585 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 243967 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00400 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 67 | NumberOfActivitiesOrPrograms |
| Persons Served | 95153 | PersonsServed |
| Total Community Benefit Expense | 2949702 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 120712 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2828990 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04670 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 67 | NumberOfActivitiesOrPrograms |
| Persons Served | 96901 | PersonsServed |
| Total Community Benefit Expense | 6906522 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 847048 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6059474 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 207 | PersonsServed |
| Total Community Building Expense | 49539 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 49539 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 243 | PersonsServed |
| Total Community Building Expense | 1962 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1962 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 414 | PersonsServed |
| Total Community Building Expense | 5351 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5351 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 35 | PersonsServed |
| Total Community Building Expense | 3515 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3515 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 899 | PersonsServed |
| Total Community Building Expense | 60367 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 60367 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,675,425 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12393249 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16303697 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3910448 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | 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 | MARGARET MARY COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MITCHELL AVENUE | AddressLine1 |
| City | BATESVILLE | City |
| State | IN | State |
| ZIP Code | 47006 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARGARET MARY COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 275.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 275.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | 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 | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| 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 | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| THE HANSEN CENTER | ||||
| 6 PINE RANCH RD | BATESVILLE | IN | 47006 | CANCER TREATMENT CENTER |
| OUTPATIENT REHABILITATION CENTER | ||||
| STATE RD 129 | BATESVILLE | IN | 47006 | THERAPY & ORTHOPEDIC CENTER |
| OCCUPATIONAL HEALTH CLINIC | ||||
| 374 NORTHSIDE DR SUITE D | BATESVILLE | IN | 47006 | CLINIC |
| WELLNESS CLINIC | ||||
| 4 W PEARL ST | BATESVILLE | IN | 47006 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 3C: FOR ELIGIBILITY GUIDELINES A SLIDING SCALE IS USED FOR DISCOUNTED CARE IF THE PATIENT IS OVER OUR 275% FEDERAL POVERTY GUIDELINES. | |
| PART I, LINE 7: THE COST TO CHARGE RATIO METHOD WAS USED TO CALCULATE THE CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. | |
| PART I, LINE 7G: N/A - ORGANIZATION DOES NOT INCLUDE ANY COST ATTRIBUTABLE TO A PHYSICIAN CLINIC IN THE SUBSIDIZED HEALTH SERVICES COSTS. | |
| PART I, L7 COL(F): TOTAL BAD DEBT EXPENSE OF $6,324,822 INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) HAS BEEN EXCLUDED FROM THE DENOMINATOR FOR THE PERCENTAGE CALCULATION PER IRS INSTRUCTION. | |
| PART II: MMCH SUPPORTS COMMUNITY BUILDING BY PARTICIPATING AND BEING AN ACTIVE PARTNER IN EMERGENCY PREPAREDNESS. MMCH PROMOTES BUILDING THE FUTURE OF HEALTHCARE BY DEVELOPING MENTOR AND CAREER DEVELOPMENT PROGRAMS IN THE HEALTHCARE FIELD. MMCH ALSO HAS A RECRUITMENT PLAN TO ENSURE ACCESS TO THE MEDICAL CARE. | |
| PART III, LINE 4: SECTION A, LINE 2 EXPLANATION: AUDITED FINANCIAL STATEMENT FOOTNOTE 1 SIGNIFICANT ACCOUNT POLICIES: MANAGEMENT ESTIMATES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE BASED ON AN EVALUATION OF HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THE HOSPITAL'S CUSTOMER BASE. PART III, LINE 4, SECTION A, LINE 3 EXPLANATION: NO OTHER BAD DEBT AMOUNTS HAVE BEEN INCLUDED AS COMMUNITY BENEFIT. THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON, THE ORGANIZATION BELIEVES IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. | |
| PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED DECEMBER 31, 2011 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. | |
| PART V, SECTION B, LINE 9: FOR ELIGIBILITY GUIDELINES A SLIDING SCALE IS USED FOR DISCOUNTED CARE IF THE PATIENT IS OVER OUR 275% FEDERAL POVERTY GUIDELINES. | MARGARET MARY COMMUNITY HOSPITAL |
| PART V, SECTION B, LINE 19D: CHARGES ARE APPLIED TO ALL ACCOUNTS AT THE TIME OF SERVICES, REGARDLESS OF WHETHER THE PATIENT IS COVERED BY INSURANCE OR NOT. ONCE INDIVIDUALS ARE DETERMINED TO MEET THE FINANCIAL ASSISTANCE POLICY REQUIREMENTS DISCOUNTS ARE APPLIED. | MARGARET MARY COMMUNITY HOSPITAL |
| PART VI, LINE 2: MMCH COMPLETES A COMMUNITY HEALTH ASSESSMENT EVERY 3 TO 5 YEARS WHICH INCLUDES FOCUS GROUPS WITH LOCAL PARTNERS AND LEADERS. | |
| PART VI, LINE 3: MMCH INFORMS AND EDUCATES PATIENTS AND PERSONS ABOUT ELIGIBILITY FOR ASSISTANCE WITH POSTED SIGNAGE IN ALL REGISTRATION AREAS AND ON OUR WEBSITE. | |
| PART VI, LINE 4: MMCH SERVES A PRIMARY AND SECONDARY MARKET THAT INCLUDED RIPLEY, FRANKLIN, AND DECATUR COUNTIES. THIS IS PRIMARILY A RURAL COMMUNITY. | |
| PART VI, LINE 5: MMCH IS GOVERNED BY A COMMUNITY BOARD. MMCH OPERATES A 24 HOUR EMERGENCY ROOM. MMCH COMPLETES A COMMUNITY ASSESSMENT AND A PLAN TO ADDRESS OUR COMMUNITY NEEDS. | |
| PART VI, LINE 6: N/A - THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.PART VI, LINE 8: LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: INDIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
| Total Nbr Of501 C3 And Govt Grants | 0 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS, FIVE RECIPIENTS RECEIVED $1,000 AND ELEVEN RECIPIENTS RECEIVED $3,000. | TypeOfGrant |
| Number Of Recipients | 16 | NumberOfRecipients |
| Amount Of Cash Grant | 38000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: ASSISTANCE TO ORGANIZATIONS: ALL GRANTS ARE PROVIDED TO 501(C)(3) PUBLIC CHARITIES FOR GENERAL SUPPORT. MARGARET MARY COMMUNITY HOSPITAL DOES NOT MONITOR THE USE OF THESE FUNDS BY THESE PUBLIC CHARITIES. ASSISTANCE TO INDIVIDUALS: SCHOLARSHIP APPLICATIONS ARE REVIEWED BY SENIOR MANAGERS AND A HUMAN RESOURCE REPRESENTATIVE. CRITERIA REVIEWED INCLUDE GPA, DEGREE PURSUING, YEAR THEY WOULD GRADUATE AND THE NEED OF MMCH. TO RECEIVE FUTURE INSTALLMENTS STUDENT MUST MAINTAIN MINIMUM 3.0 GPA AND PROVIDE A COPY OF TRANSCRIPTS. | 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 | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY PUTNAM | |||||||||||||
| 258516 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 31376 | 0 | 297242 | 0 | 0 | 0 |
| JEFFREY HATCHER MD | |||||||||||||
| 432932 | 0 | 0 | 0 | 0 | 0 | 22350 | 0 | 35957 | 0 | 491239 | 0 | 0 | 0 |
| BRIAN DAEGER | |||||||||||||
| 190320 | 0 | 0 | 0 | 0 | 0 | 5751 | 0 | 28344 | 0 | 224415 | 0 | 0 | 0 |
| JULIE KEENE | |||||||||||||
| 128076 | 0 | 0 | 0 | 0 | 0 | 3907 | 0 | 28340 | 0 | 160323 | 0 | 0 | 0 |
| NANCY MARTICKE | |||||||||||||
| 190141 | 0 | 0 | 0 | 0 | 0 | 5760 | 0 | 30451 | 0 | 226352 | 0 | 0 | 0 |
| KIM INSCHO | |||||||||||||
| 160584 | 0 | 0 | 0 | 0 | 0 | 4871 | 0 | 29062 | 0 | 194517 | 0 | 0 | 0 |
| THOMAS BROWN MD | |||||||||||||
| 375365 | 0 | 0 | 0 | 0 | 0 | 5410 | 0 | 33697 | 0 | 414472 | 0 | 0 | 0 |
| BRIAN ALBERS MD | |||||||||||||
| 372869 | 0 | 0 | 0 | 0 | 0 | 22350 | 0 | 36910 | 0 | 432129 | 0 | 0 | 0 |
| JON GEERS MD | |||||||||||||
| 342588 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 30184 | 0 | 372772 | 0 | 0 | 0 |
| KIMBERLY KICK MD | |||||||||||||
| 230729 | 0 | 0 | 0 | 0 | 0 | 6977 | 0 | 29815 | 0 | 267521 | 0 | 0 | 0 |
| THOMAS DECILLES MD | |||||||||||||
| 207847 | 0 | 0 | 0 | 0 | 0 | 6316 | 0 | 27815 | 0 | 241978 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | MR. PUTNAM AND MR. HATCHER SERVE AS BOARD MEMBER AND ARE EMPLOYEES OF MARGARET MARY COMMUNITY HOSPITAL. THEIR HOURS AND COMPENSATION DOCUMENTED ON THE FORM 990, PART VII AND SCHEDULE J RELATE THEIR DUTIES AS EMPLOYEES OF THE HOSPITAL. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| INDIANA HEALTH FACILITY FINANCING AUTHORITY | |||||||
| 351611409 | 454798PAL | 2004-04-01 | 22000000 | FINANCE ONCOLOGY AND OUTPATIENT CENTERS | 0 | 0 | 0 |
| INDIANA FINANCE AUTHORITY | |||||||
| 351602316 | 2010-12-16 | 16625235 | REFINANCE 2008 BONDS AND FINANCE 28,000 SQUARE FEET MEDICAL OFFICE BUILDING. | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capitalized InterestCapitalizedInterest | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|
| 22000000 | 264000 | 21736000 | 2004 | 0 | 0 | 1 | 0 | |||
| 16625235 | 16625 | 3162004 | 2012 | 0 | 1 | 0 | 0 | 379878 | 8625235 | 4821371 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Business Name Line2NameOfHedgeProvider/BusinessNameLine2 | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|---|---|---|
| PIPER JAFFRAY | |||||||||
| 0 | 1 | 1 | FINANCIAL PRODUCTS | 25.000000000000 | 0 | 0 | 0 | 0 | 1 |
| (no name) | |||||||||
| 0 | 1 | 0 | 0 | 0 | 1 | ||||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. ALL ADULT RESIDENTS OF THE AREA SERVED BY MARGARET MARY COMMUNITY HOSPITAL SHALL BE ELIGIBLE FOR MEMBERSHIP IN THE ORGANIZATION. ANY SUCH RESIDENT MAY BECOME A MEMBER BY PAYMENT OF THE ANNUAL MEMBERSHIP FEE PROVIDED FOR IN THE BY-LAWS OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH MEMBER WHOSE CURRENT ANNUAL MEMBERSHIP HAS BEEN PAID AT LEAST TEN DAYS IN ADVANCE OF ANY MEETING SHALL BE ENTITLED TO ONE VOTE AT ANY MEETING OF THE MEMBERS. THE MEMBERS OF THE ORGANIZATION ELECT THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE FORM 990 IS THEN PRESENTED AND REVIEWED WITH THE FINANCE COMMITTEE. ONCE APPROVED BY THE FINANCE COMMITTEE, THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY BRIAN DAEGER, MMCH CORPORATE COMPLIANCE OFFICER. THE SCOPE OF THIS POLICY INCLUDES ALL BOARD AND FINANCE COMMITTEE MEMBERS, SENIOR MANAGEMENT OF MMCH, AND ANY PHYSICIAN WHO HOLDS A MEDICAL DIRECTORSHIP POSITION AT MMCH. THE POLICY IS IN PLACE TO IDENTIFY AND APPROPRIATELY DEAL WITH A CONFLICT OF INTEREST SITUATION THAT MAY EXIST. THE COVERED PERSONS ARE TO REFRAIN FROM TRANSACTIONS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. A SELF DISCLOSURE FROM COVERED PERSONS TO BRIAN DAEGER, MMCH CORPORATE COMPLIANCE OFFICER, IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. DEPENDING ON THE TYPE OF CONFLICT OF INTEREST, THE COVERED PERSON WOULD NOT PARTICIPATE IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. THIS WOULD INCLUDE ABSTAINING FROM VOTING ON CERTAIN MATTERS. BRIAN DAEGER, MMCH CORPORATE COMPLIANCE OFFICER, IS RESPONSIBLE FOR REVIEWING AND RESEARCHING THE CONFLICTS DISCLOSED. | |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO COMPENSATION DETERMINED BY BOARD. OTHER OFFICERS OR KEY EMPLOYEES COMPENSATION DETERMINED BY CEO. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -3,823,395. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| OVERSIGHT OF AUDIT | THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. |
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