BOLIVAR MEDICAL CENTER FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BOLIVAR MEDICAL CENTER FOUNDATION (EIN 64-0923090)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-03-07
IRS object ID
201240679349300814
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

FieldValueIRS element (for citing)
Timestamp2012-03-07T11:09:04-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JACKSON & BRASWELL PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 298AddressLine1
CityCLEVELANDCity
StateMSState
ZIP Code38732ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN640923090EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BOLIVAR MEDICAL CENTER FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBOLINameControl
Phone6628431555Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 298AddressLine1
CityCLEVELANDCity
StateMSState
ZIP Code38732ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK HARGETTName
TitleCHAIRMANTitle
Phone6628431555Phone
Date Signed2012-03-06DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKENNETH E MULLINSName
Phone6628431555Phone
Date Prepared2012-03-07DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts17300659GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileMSStateLegalDomicile
Activity Or Mission DescriptionTHE PURPOSE OF THE FOUNDATION IS TO PROMOTE THE HEALTH OF THE CITIZENS OF BOLIVAR COUNTY, MISSISSIPPI.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year3326096InvestmentIncomePriorYear
Investment Income Current Year799269InvestmentIncomeCurrentYear
Other Revenue Prior Year782OtherRevenuePriorYear
Other Revenue Current Year63OtherRevenueCurrentYear
Total Revenue Prior Year3326878TotalRevenuePriorYear
Total Revenue Current Year799332TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year480714GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year184081OtherExpensePriorYear
Other Expenses Current Year527690OtherExpensesCurrentYear
Total Expenses Prior Year664795TotalExpensesPriorYear
Total Expenses Current Year527690TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2662083RevenuesLessExpensesPriorYear
Revenues Less Expenses CY271642RevenuesLessExpensesCY
Total Assets BOY35221240TotalAssetsBOY
Total Assets EOY35492881TotalAssetsEOY
Total Liabilities BOY335478TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY34885762NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY35492881NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PURPOSE OF THE FOUNDATION IS TO PROMOTE THE HEALTH OF THE CITIZENS OF BOLIVAR COUNTY, MISSISSIPPI.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense335477Expense
DescriptionBOLIVAR COUNTY, MISSISSIPPIDescription
Total Program Service Expense335477TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JACKSON & BRASWELLBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6628431555TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 298AddressLine1
CityCLEVELANDCity
StateMSState
ZIP Code38732ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KENT WYATT
DIRECTORX000
MAURICE LUCAS
VICE CHAIRMAX000
CANDY DAVIS
DIRECTORX000
JEANIE WALKER
SECRETARYX000
DARRYL JOHNSON
DIRECTORX000
MARK HARGETT
CHAIRMANX000
ROY COLLINS
DIRECTORX000
NED TOLLIVER
TREASURERX000
BENNIE WRIGHT
DIRECTORX000
DON BLACKWOOD
DIRECTORX000
GEORGENNE CLARK
DIRECTORX000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column864796TotalRevenueColumn
Related Or Exempt Function Income864796RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities16388879Securities
Other46921Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities16501327Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-112448Securities
Other46921Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-65527TotalRevenueColumn
Related Or Exempt Function Income-65527RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Total Revenue Column63TotalRevenueColumn
Related Or Exempt Function Income63RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue63TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column799332TotalRevenueColumn
Related Or Exempt Function Income799332RelatedOrExemptFunctionIncome

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total7043Total
Management And General7043ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total24270Total
Management And General24270ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
INDIGENT CARE200000200000
AMBULATORY CARE135477135477
INVESTMENT FEES131105131105
INVESTMENT ADVISOR2400024000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5795Total
Management And General5795ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total527690Total
Program Services335477ProgramServices
Management And General192213ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY115711BOY
EOY193000EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY34801529BOY
EOY34955881EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY304000BOY
EOY344000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY35221240BOY
EOY35492881EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY335478BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY335478BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY34885762BOY
EOY35492881EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY34885762BOY
EOY35492881EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY35221240BOY
EOY35492881EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses271642ReconcilationRevenueExpenses
Reconcilation Other Changes335477ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Governmental Unit170b1 AvXGovernmentalUnit170b1Av

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR
Total Revenue799332TotalRevenue
Total Expenses527690TotalExpenses
Excess Or Deficit For Year271642ExcessOrDeficitForYear
Excess Or Deficit Per FS271642ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt799332TotRevenueEtcAuditedFinclStmt
Revenue Subtotal799332RevenueSubtotal
Total Revenue Per Form990799332TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt527690TotExpensesEtcAuditedFinclStmt
Expenses Subtotal527690ExpensesSubtotal
Total Expenses Per Form990527690TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC

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