MORRISTOWN-HAMBLEN HOSPITAL: Form 990, tax year 2011
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- Organization
- MORRISTOWN-HAMBLEN HOSPITAL (EIN 62-1697090)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-13
- IRS object ID
- 201233189349301323
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-13T09:11:15-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621697090 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Morristown-Hamblen Hospital Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MORR | NameControl |
| Phone | 8653746864 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1 |
| City | Knoxville | City |
| State | TN | State |
| ZIP Code | 379321960 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN T GEPPI | Name |
| Title | EVP/CFO | Title |
| Phone | 8653746872 | Phone |
| Date Signed | 2012-11-07 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Self prepared | Name |
| 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 | George O Haggard Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 908 W 4th North St | AddressLine1 |
| City | Morristown | City |
| State | TN | State |
| ZIP Code | 37814 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 526257 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | http://www.mhhs1.org/foundation | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | TN | StateLegalDomicile |
| Activity Or Mission Description | To support the Morristown-Hamblen Healthcare System. See Form 990, Part III. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 73 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 155476 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 466948 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1586 | InvestmentIncomePriorYear |
| Investment Income Current Year | 604 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 14042 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4320 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 171104 | TotalRevenuePriorYear |
| Total Revenue Current Year | 471872 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4110 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 77524 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 60646 | OtherExpensePriorYear |
| Other Expenses Current Year | 124240 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 60646 | TotalExpensesPriorYear |
| Total Expenses Current Year | 128350 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 110458 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 343522 | RevenuesLessExpensesCY |
| Total Assets BOY | 1458790 | TotalAssetsBOY |
| Total Assets EOY | 1763514 | TotalAssetsEOY |
| Total Liabilities BOY | 163514 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 124716 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1295276 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1638798 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The purpose of the Morristown-Hamblen Hospital Foundation is to support the Morristown-Hamblen Healthcare System in promoting and advancing the well-being of our community by providing quality healthcare and health-related services. The Foundation provides philanthropic support to the Morristown-Hamblen Healthcare System through the generosity of individuals, corporations, and foundations in the community and supports the hospital's mission "to serve the community by improving the quality of life through better health." | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4110 | Expense |
| Grants | 4110 | Grants |
| Revenue | 466948 | Revenue |
| Description | Morristown-Hamblen Hospital Foundation raised funds to provide for indigent patient care and services that were not funded by the health system, private insurance, or other reimbursement. The Foundation also has an active fundraising campaign underway for an 8-bed inpatient oncology unit at Morristown-Hamblen Healthcare System (MHHS). The objective is to raise two million dollars for the building project. During the current reporting period, $208,641 was raised toward the campaign. MHHS currently has an outpatient cancer center offering medical oncology, chemotherapy, radiation oncology and radiation therapy. The new unit will offer the highest level of cancer care for inpatients with specially trained clinical staff and will complete the continuum of care with the outpatient center. | Description |
| Total Program Service Expense | 4110 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 | 1 | 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 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 1 | 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 | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | TN | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tina Robertson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8653746864 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1 |
| City | Knoxville | City |
| State | TN | State |
| ZIP Code | 379321960 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (10 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 |
|---|---|---|---|---|---|---|---|
| George O Haggard Jr | |||||||
| Chairman | 1.00 | X | X | 0 | 0 | 0 | |
| Jack Maloney | |||||||
| Vice President | 1.00 | X | 0 | 0 | 0 | ||
| Jennie Morris | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Harold Nichols | |||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | ||
| Shahin Assadnia MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| R Jack Fishman | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Marjory Houston | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Anthony Stapleton | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Carl Storms | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Pamela Snyder | |||||||
| Exec. Dir./MHHS Dir. of Ma | 14.00 | 0 | 105751 | 17813 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 105751 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 17813 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Morristown-Hamblen Hospital Association | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 908 W 4th North St | AddressLine1 |
| City | Morristown | City |
| State | TN | State |
| ZIP Code | 37814 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Staffing | DescriptionOfServices |
| Compensation | 108045 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 84648 | FundraisingEvents |
| Related Organizations | 293835 | RelatedOrganizations |
| All Other Contributions | 88465 | AllOtherContributions |
| Noncash Contributions | 14065 | NoncashContributions |
| Total Contributions | 466948 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 604 | TotalRevenueColumn |
| Exclusion | $604 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 30430 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2101 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 28329 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28329 | TotalRevenueColumn |
| Exclusion | $28,329 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 28275 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 84648 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 52284 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -24009 | TotalRevenueColumn |
| Exclusion | -$24,009 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 471872 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $4,924 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1812 | Total |
| Program Services | 1812 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2298 | Total |
| Program Services | 2298 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2000 | Total |
| Management And General | 2000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108570 | Total |
| Management And General | 40558 | ManagementAndGeneral |
| Fundraising | 68012 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3362 | Total |
| Fundraising | 3362 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1333 | Total |
| Management And General | 421 | ManagementAndGeneral |
| Fundraising | 912 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 282 | Total |
| Management And General | 56 | ManagementAndGeneral |
| Fundraising | 226 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3588 | Total |
| Management And General | 2012 | ManagementAndGeneral |
| Fundraising | 1576 | Fundraising |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|
| Miscellaneous Expense | 2552 | 1169 | 1383 |
| Meals and Entertainment | 2053 | 2053 | |
| Dues and Licenses | 500 | 500 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 128350 | Total |
| Program Services | 4110 | ProgramServices |
| Management And General | 46716 | ManagementAndGeneral |
| Fundraising | 77524 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 859465 | BOY |
| EOY | 250 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 250000 | BOY |
| EOY | 1426308 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34833 | BOY |
| EOY | 25967 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3503 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 327000 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 16011 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 310989 | BOY |
| EOY | 310989 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1458790 | BOY |
| EOY | 1763514 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4631 | BOY |
| EOY | 251 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147155 | BOY |
| EOY | 121155 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11728 | BOY |
| EOY | 3310 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 163514 | BOY |
| EOY | 124716 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1295276 | BOY |
| EOY | 1638798 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1295276 | BOY |
| EOY | 1638798 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1458790 | BOY |
| EOY | 1763514 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 343522 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | 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 Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | M-H Hospital Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 620545814 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $788 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 788 | SumOfAmounts |
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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | 197694 | Contributions |
| Grants Or Scholarships | 1936 | GrantsOrScholarships |
| Other Expenditures | 5442 | OtherExpenditures |
| End Of Year Balance | 190316 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 1.00000 | 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 | 310989 | OtherCostOrOtherBasis |
| Book Value | 310989 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16011 | OtherCostOrOtherBasis |
| Depreciation | 16011 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 310989 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to Affiliates | Description |
| Amount | $3,310 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3310 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | Endowments consist of temporarily restricted funds established by donor-restricted gifts for one of the following: Cancer Patient Fund, Oncology Capital Campaign Fund, Education Fund, or Heart, Lung, and Vascular Fund. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | Note G to the consolidated audited financial statements of Covenant Health, parent company of the consolidated group of which Morristown-Hamblen Hospital Foundation is a member, reads in part: At December 31, 2011, tax returns for 2008 through 2011 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition on disclosure under generally accepted accounting principles at December 31, 2011 or 2010. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Golf Tournament | NameOfEvent1 |
| Gross Receipts Event1 | 56785 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 50520 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 6265 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 6950 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 384 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 11400 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Heart Gala Auction | NameOfEvent2 |
| Gross Receipts Event2 | 56138 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 34128 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 22010 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 750 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 19279 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 1150 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 12371 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 112923 | GrossReceiptsTotal |
| Charitable Contributions Total | 84648 | CharitableContributionsTotal |
| Gross Revenue Total Events | 28275 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 7700 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 19663 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 1150 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 23771 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 52284 | DirectExpenseSummaryEvents |
| Net Income Summary | -24009 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | Morristown-Hamblen Hospital Foundation has one member, Morristown-Hamblen Hospital Association (MHHA), a Tennessee nonprofit corporation. | |
| Form 990, Part VI, Section A, line 7a | Per provisions in Article III, Section 3 of the Foundation's ByLaws, the Board of Directors of Morristown-Hamblen Hospital-Association shall nominate and elect members of the Foundation board of directors and fill vacancies on the board as often as vacancies occur, whether such vacancies are due to expansion, resignation, expiration of term, death or for any other reason and designate the term of service of each elected member of the board. | |
| Form 990, Part VI, Section A, line 7b | Amendments to the ByLaws must be approved by a majority vote of the Board of Directors of the Foundation's sole member, Morristown-Hamblen Hospital Association. | |
| Form 990, Part VI, Section B, line 11 | Morristown-Hamblen Hospital Foundation's 2011 Form 990 was presented to the Foundation's Board of Directors at its meeting in October 2012. | |
| Form 990, Part VI, Section B, line 12c | Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health, the parent company of Morristown-Hamblen Hospital Association, distributes a Board-approved employee handbook to all employees. The handbook covers among other subjects, conflicts of interest. Additionally, managers are required to complete and sign an annual management certification that addresses conflicts of interest. Board members' conflicts of interests are dealt with in the corporate bylaws, and Board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity Compliance Office maintains records that contain conflict of interest information obtained from Board members, officers and employees. These records are available to be queried prior to engaging in business transactions. The Integrity Compliance Officer initially reviews all conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected Board members are expected to disclose any new conflicts that have arisen that affect pending Board decisions. As well, managers and other employees are expected to report conflicts to the Integrity Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Integrity Compliance Officer, Senior Leadership, or the Board of Directors may review the conflict of interest. Where appropriate these bodies may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Integrity Compliance Officer in conjunction with Executive Leadership determines how to appropriately handle the conflict. In any conflict involving a Board member, such member is expected to excuse himself or herself from voting on matters that give rise to the conflict. | |
| Form 990, Part VI, Section B, line 15a | The base salary for Pamela Snyder, former Executive Director, was based on established targets to insure that total compensation was reasonable and within a fair market value range. Salary ranges for each executive position are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and vary according to the individual's experience, market conditions and competition. | |
| Form 990, Part VI, Section C, line 19 | Form 990, Part VI, Section C, Line 19: Morristown-Hamblen Hospital Foundation makes its governing documents and financial statements available to the public upon request. | |
| Form 990, Part VII, Section A, Col. (B) - | Pamela Snyder is compensated by Morristown-Hamblen Hospital Association d/b/a Morristown Hamblen Healthcare System for her service to the system as a whole. Average hours per week devoted to the Morristown-Hamblen Hospital Foundation are reported on this return. | Hours Worked for Related Organizations: |
| Form 990, Part XII, Line 2c: | The Finance Committee of the Covenant Health Board of Directors assumes responsibility for oversight of the audit of the consolidated financial statements and selection of an independent accountant. Covenant Health is the parent company of Morristown-Hamblen Hospital Association, the sole member of Morristown-Hamblen Hospital Foundation. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Morristown-Hamblen Hospital Assocation dba M-H Healthcare System | ||||||||||
| 908 West Fourth North Street | Morristown | TN | 37814 | 620545814 | Hospital Services | TN | 501(c)(3) | Line 3 | Covenant Health | 0 |
| Morristown Regional Cancer Center LLC | ||||||||||
| 908 West Fourth North Street | Morristown | TN | 37814 | 200916364 | Cancer Treatment Facility | TN | 501(c)(3) | Line 3 | Morristown-Hamblen Hospital Association | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Assoc of the Meridian Health Outpatient Surgery Ctr LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 908 W 4th North St | AddressLine1 |
| City | Morristown | City |
| State | TN | State |
| ZIP Code | 37814 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861167487 | EIN |
| Primary Activity | Healthcare Services | PrimaryActivity |
| Legal Domicile State | TN | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Morristown Hamblen Health Services Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1178 | AddressLine1 |
| City | Morristown | City |
| State | TN | State |
| ZIP Code | 37816 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621588521 | EIN |
| Primary Activity | Inactive (dissolved 2/5/2011) | PrimaryActivity |
| Legal Domicile State | TN | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
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