NMC SERVICES INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- NMC SERVICES INC (EIN 62-1046595)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-04-23
- IRS object ID
- 201241149349300124
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-04-23T14:09:51-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HORNE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1020 HIGHLAND COLONY PKWY STE 400 | AddressLine1 |
| City | RIDGELAND | City |
| State | MS | State |
| ZIP Code | 39157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621046595 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHCREST MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 6153841711 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST MEDICAL CENTER | AddressLine1 |
| City | SPRINGFIELD | City |
| State | TN | State |
| ZIP Code | 371723961 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES F SCHMIDT | Name |
| Title | CFO | Title |
| Phone | 6153841711 | Phone |
| Date Signed | 2012-04-23 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARSHA H DIECKMAN CPA | Name |
| Phone | 6013261000 | Phone |
| Date Prepared | 2012-04-23 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES F SCHMIDT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST MEDICAL CENTER | AddressLine1 |
| City | SPRINGFIELD | City |
| State | TN | State |
| ZIP Code | 371723961 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 74170728 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NORTHCREST.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | TN | StateLegalDomicile |
| Activity Or Mission Description | OPERATION OF A NONPROFIT 109-BED ACUTE CARE FACILITY IN SPRINGFIELD, TENNESSEE | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 790 | TotalNbrEmployees |
| Total Nbr Volunteers | 63 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 453302 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 388471 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 74109475 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 72571125 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 249254 | InvestmentIncomePriorYear |
| Investment Income Current Year | 216782 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1114012 | OtherRevenuePriorYear |
| Other Revenue Current Year | 993596 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 75926043 | TotalRevenuePriorYear |
| Total Revenue Current Year | 74169974 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 157982 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 207026 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 29748022 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29541697 | 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 | 44329455 | OtherExpensePriorYear |
| Other Expenses Current Year | 44042990 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 74235459 | TotalExpensesPriorYear |
| Total Expenses Current Year | 73791713 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1690584 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 378261 | RevenuesLessExpensesCY |
| Total Assets BOY | 78506202 | TotalAssetsBOY |
| Total Assets EOY | 80290027 | TotalAssetsEOY |
| Total Liabilities BOY | 58893212 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 61496610 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 19612990 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 18793417 | NetAssetsOrFundBalancesEOY |
| Mission Description | NORTHCREST MEDICAL CENTER IS A TENNESSEE NONPROFIT CORPORATION THAT OPERATES A 109-BED GENERAL ACUTE CARE FACILITY. THE HOSPITAL PROVIDES A FULL RANGE OF MEDICAL SERVICES TO BOTH INPATIENTS AND OUTPATIENTS IN AND AROUND THE SPRINGFIELD, TENNESSEE AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 69526749 | Expense |
| Grants | 207026 | Grants |
| Revenue | 72914876 | Revenue |
| Description | IN ADDITION TO HEALTH CARE SERVICES, NORTHCREST MEDICAL CENTER SPONSORS MONTHLY SUPPORT GROUPS FOR GRIEF, CANCER AND DIABETES EDUCATION, HOSTS PRENATAL CLASSES, PUBLISHES A QUARTERLY NEWSLETTER, AND PROVIDES STROKE AND PROSTATE CANCER SCREENINGS ALONG WITH FREE BLOOD PRESSURE CHECKS. NORTHCREST MEDICAL CENTER ALSO CONDUCTS SEMINARS ON EXERCISE, NUTRITION, WEIGHT LOSS, ARTHRITIS, AND SODIUM PROTECTION. | Description |
| Total Program Service Expense | 69526749 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | 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 | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 86 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 790 | 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 | 0 | QuidProQuoContributions |
| 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 | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JAMES SCHMIDT | NamePerson |
| Telephone Number | 6153841503 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1 |
| City | SPRINGFIELD | City |
| State | TN | State |
| ZIP Code | 37172 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| TED STUBBLEFIELD | ||||||||
| TRUSTEE, CHAIRMAN | 1.00 | X | 3000 | 0 | 0 | |||
| DAVID BELLAR | ||||||||
| TRUSTEE, VICE CHAIRMAN | 1.00 | X | 3000 | 0 | 0 | |||
| JAMES G BOWENS | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| HOWARD BRADLEY | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| TOMMY CRUNK | ||||||||
| TRUSTEE | 1.00 | X | 57028 | 0 | 0 | |||
| GEORGE DAHIR | ||||||||
| TRUSTEE | 1.00 | X | 2500 | 471528 | 23900 | |||
| GERALDINE FARMER | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| ALVIN FOWLER | ||||||||
| TRUSTEE, SECRETARY | 1.00 | X | 3000 | 0 | 0 | |||
| AMY GALLAGHER | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| E DEE REID | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| TRACY LANGSTON | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| DAN GREEN | ||||||||
| TRUSTEE | 1.00 | X | 3000 | 0 | 0 | |||
| SCOTT RAYNES | ||||||||
| PRESIDENT/CEO | 40.00 | 386127 | 0 | 51808 | X | |||
| JIM SCHMIDT | ||||||||
| CFO | 40.00 | 199630 | 0 | 34590 | X | |||
| RANDY MILLS | ||||||||
| VICE PRESIDENT - BUSINESS | 40.00 | 191235 | 0 | 27507 | X | |||
| ANGELA BEARD | ||||||||
| CNO | 40.00 | 184876 | 0 | 22054 | X | |||
| AMBER KING | ||||||||
| VICE PRESIDENT - HUMAN RESOURCES | 40.00 | 102193 | 0 | 30160 | X | |||
| RANDY DAVIS | ||||||||
| CIO | 40.00 | 151897 | 0 | 33079 | X | |||
| JOAN CHATHAM | ||||||||
| QA/PI DIRECTOR | 40.00 | 109832 | 0 | 12083 | X | |||
| LISA LINVILLE | ||||||||
| CCU DIRECTOR | 40.00 | 105642 | 0 | 11854 | X | |||
| MIKE TINAL | ||||||||
| PFS DIRECTOR | 40.00 | 100956 | 0 | 14407 | X | |||
| SHARON JEHLE | ||||||||
| FORMER KEY EMPLOYEE AND FORMER CNO | 0.00 | 149026 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1770942 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 471528 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 261442 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| GOLDEN LIVING CENTER | |||||
| 104 WATSON ROAD | SPRINGFIELD | TN | 37172 | NURSING HOME CARE FOR HOSPICE PATIENTS | 218982 |
| JJCA-JOHNSON JOHNSON CRABTREE | |||||
| 4551 TROUSDALE DRIVE | NASHVILLE | TN | 37204 | ARCHITECTS | 213140 |
| MCCLEAREN DESIGN STUDIOS | |||||
| PO BOX 60676 | NASHVILLE | TN | 37206 | GRAPHIC DESIGN AND PRINTING SERVICES | 169869 |
| FAVORITE HEALTHCARE STAFFING INC | |||||
| PO BOX 803356 | KANSAS CITY | MO | 64180 | NURSE STAFFING | 155929 |
| LEE MEDICAL | |||||
| PO BOX 682027 | FRANKLIN | TN | 37068 | IV MANAGMENT SERVICES; EDC INSERTIONS | 145150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Related Organizations | 32531 | RelatedOrganizations |
| Government Grants | 22512 | GovernmentGrants |
| All Other Contributions | 333428 | AllOtherContributions |
| Total Contributions | 388471 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | HEALTHCARE REVENUE | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 72571125 | TotalRevenueColumn |
| Related Or Exempt Function Income | 72571125 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 72571125 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 208098 | TotalRevenueColumn |
| Exclusion | $208,098 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 658529 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 658529 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 658529 | TotalRevenueColumn |
| Exclusion | $658,529 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9438 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 754 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 8684 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8684 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8684 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CAFETERIA SALES | 722210 | 295383 | 295383 |
| MISCELLANEOUS | 623990 | 27531 | 27531 |
| VENDING MACHINES | 623990 | 12153 | 12153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 335067 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 74169974 | TotalRevenueColumn |
| Related Or Exempt Function Income | 72914876 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $866,627 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207026 | Total |
| Program Services | 207026 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1564183 | Total |
| Program Services | 864267 | ProgramServices |
| Management And General | 699916 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23374197 | Total |
| Program Services | 22543210 | ProgramServices |
| Management And General | 830987 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2621519 | Total |
| Program Services | 2495840 | ProgramServices |
| Management And General | 125679 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1981798 | Total |
| Program Services | 1894411 | ProgramServices |
| Management And General | 87387 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 295276 | Total |
| Program Services | 292565 | ProgramServices |
| Management And General | 2711 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 274302 | Total |
| Program Services | 121267 | ProgramServices |
| Management And General | 153035 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1206858 | Total |
| Program Services | 1201304 | ProgramServices |
| Management And General | 5554 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133856 | Total |
| Program Services | 90122 | ProgramServices |
| Management And General | 43734 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3358265 | Total |
| Program Services | 3358265 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4584299 | Total |
| Program Services | 4584299 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4060982 | Total |
| Program Services | 3642444 | ProgramServices |
| Management And General | 418538 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 11032786 | 11014215 | 18571 |
| BAD DEBT EXPENSE | 9061368 | 9061368 | |
| CONTRACT SERVICES | 4216627 | 2682381 | 1534246 |
| EQUIPMENT RENTAL AND MA | 4124455 | 3997198 | 127257 |
| MEDICAL SPECIALIST | 426917 | 426917 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1266999 | Total |
| Program Services | 1049650 | ProgramServices |
| Management And General | 217349 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73791713 | Total |
| Program Services | 69526749 | ProgramServices |
| Management And General | 4264964 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1633297 | BOY |
| EOY | 3713295 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18964934 | BOY |
| EOY | 10527262 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7254181 | BOY |
| EOY | 10353178 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1274400 | BOY |
| EOY | 948436 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1252975 | BOY |
| EOY | 1284286 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 647377 | BOY |
| EOY | 773417 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 81242112 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 47950552 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33120401 | BOY |
| EOY | 33291560 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3443452 | BOY |
| EOY | 6070830 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10915185 | BOY |
| EOY | 13327763 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78506202 | BOY |
| EOY | 80290027 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3911440 | BOY |
| EOY | 5294261 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41841573 | BOY |
| EOY | 41860171 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13140199 | BOY |
| EOY | 14342178 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58893212 | BOY |
| EOY | 61496610 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19612990 | BOY |
| EOY | 18793417 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19612990 | BOY |
| EOY | 18793417 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78506202 | BOY |
| EOY | 80290027 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 378261 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1197834 | 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) |
|---|---|---|
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3059050 | OtherCostOrOtherBasis |
| Book Value | 3059050 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 41290477 | OtherCostOrOtherBasis |
| Depreciation | 22590987 | Depreciation |
| Book Value | 18699490 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34651076 | OtherCostOrOtherBasis |
| Depreciation | 25359565 | Depreciation |
| Book Value | 9291511 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2241509 | OtherCostOrOtherBasis |
| Book Value | 2241509 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 33291560 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | U.S. TREASURY SECURITIES AND OBLIGATIONS | Description |
| Book Value | 6070830 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 6070830 | TotalOfBookValueSecurities |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENT IN STRATEGIC SERVICES | 2764 |
| UNAMORTIZED BOND ISSUE COSTS | 549428 |
| DUE FROM AFFILIATES | 12496230 |
| THIRD-PARTY SETTLEMENTS | 136101 |
| OTHER RECEIVABLES | 143240 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 13327763 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INVESTMENT IN PHYSICIAN SERVICES | $10,435,216 |
| INTEREST RATE SWAP AGREEMENT | $3,906,962 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 14342178 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE HOSPITAL'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES THE DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS AND REQUIRED DISCLOSURES. THE HOSPITAL HAS DETERMINED THAT THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2011 OR 2010. IF INTEREST AND PENALTIES ARE INCURRED RELATED TO UNCERTAIN TAX POSITIONS, SUCH AMOUNTS WOULD BE RECOGNIZED IN INCOME TAX EXPENSE. TAX PERIODS FOR ALL FISCAL YEARS AFTER 2007 REMAIN OPEN TO EXAMINATION BY THE FEDERAL AND STATE TAXING JURISDICTIONS TO WHICH THE HOSPITAL IS SUBJECT. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| 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 | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1227620 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1227620 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01900 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12700672 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10469165 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2231507 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03450 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13928292 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10469165 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3459127 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05350 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12272 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12272 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 147036 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8901 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 138135 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 159308 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8901 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 150407 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14087600 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10478066 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3609534 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05580 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,937,490 | BadDebtExpenseAmount |
| Amount Attributable To | 293749 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 18892486 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 20579602 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1687116 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | 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 | NORTHCREST MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1 |
| City | SPRINGFIELD | City |
| State | TN | State |
| ZIP Code | 37186 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOT REQUIRED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| NORTHCREST IMAGING AND SPECIALTY CLINIC | ||||
| 2536 HWY 49 SUITE 120 | PLEASANT VIEW | TN | 37172 | DIAGNOSTIC CENTER |
| NORTHCREST MEDICAL CARE IN WHITE HOUSE | ||||
| 121 HWY 76 | WHITE HOUSE | TN | 37188 | DIAGNOSTIC CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: FREE CARE IS PROVIDED BASED ON 200% OF FPG. CARE IS DISCOUNTED BASED ON SIMILAR CRITERIA FROM INSURANCE ARRANGEMENTS WITH PROVIDERS. FPG IS NOT USED WHEN DETERMINING THE DISCOUNTED CARE AMOUNT. |
| PART I, LINE 7: THE COSTING METHOD USED WAS DERIVED FROM WORKSHEET 2. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 9061368. |
| PART III, LINE 4: THE COST OF BAD DEBT WAS CALCULATED USING THE COST TO CHARGE RATIO FROM WORKSHEET 2. THE AMOUNT OF BAD DEBT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS QUALIFYING FOR CHARITY CARE IS ESTIMATED AT 10% BASED ON THE PERCENT OF SELF-PAY PROJECTED TO THE TOTAL. THE FINANCIAL STATEMENT FOOTNOTE READS: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FOR SERVICES RENDERED COLLECTIBLE FROM FEDERAL AND STATE AGENCIES (UNDER THE MEDICARE AND MEDICAID/TENNCARE PROGRAMS), MANAGED HEALTH PLANS, COMMERCIAL INSURANCE COMPANIES, WORKERS' COMPENSATION, EMPLOYERS AND PATIENTS. RECEIVABLES ARE GENERALLY UNCOLLATERALIZED, BUT CREDIT RISK RELATING TO ACCOUNTS RECEIVABLE IS LIMITED TO SOME EXTENT BY THE DIVERSITY AND NUMBER OF PATIENTS AND PAYORS. LATE FEES AND INTEREST CHARGES, IF ANY, ARE RECOGNIZED WHEN RECEIVED. THE HOSPITAL MANAGES THE RECEIVABLES BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE AMOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED ON HISTORICAL LOSSES AND AN ANALYSIS OF CURRENTLY OUTSTANDING AMOUNTS. THIS ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS GENERALLY INCREASED BY CHARGES TO A PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND DECREASED BY WRITE OFFS OF ACCOUNTS DETERMINED BY MANAGMENT TO BE UNCOLLECTIBLE. |
| PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE TAKEN FROM THE HOSPITAL'S COST REPORT. |
| PART III, LINE 9B: THERE ARE NO COLLECTION EFFORTS TAKEN ON THE PATIENTS THAT QUALIFY FOR CHARITY CARE. THEIR ACCOUNTS ARE WRITTEN OFF SO NO MONEY IS OWED AND NO CHARGES ARE RECORDED AS INCOME. |
| PART VI, LINE 2: NORTHCREST MEDICAL CENTER IS ALWAYS LOOKING FOR BETTER WAYS TO SERVE ITS COMMUNITY. WE USE MANY DIFFERENT SURVEYS TO GATHER INFORMATION ABOUT OUR HEALTHCARE SERVICES FROM OUR COMMUNITY. THE PATIENT SATISFACTION SURVEY PROVIDES OUR PATIENTS WITH THE OPPORTUNITY TO TELL US HOW WELL WE ARE PROVIDING OUR SERVICES. THE COMMUNITY PERCEPTION SURVEY ALLOWS THOSE THAT MAY NOT USE OUR FACILITY THE ABILITY TO PROVIDE US FEEDBACK ALSO. ANOTHER OPPORTUNITY FOR FEEDBACK IS THE COMMUNITY NEEDS SURVEY WHICH ALLOWS THE COMMUNITY TO EXPRESS WHAT ADDITIONAL SERVICES IT WOULD LIKE FOR US TO PROVIDE. |
| PART VI, LINE 3: PATIENTS ARE SCREENED UPON REGISTRATION TO SEE IF THEY QUALIFY FOR CHARITY CARE. THE PAPERWORK IS EXPLAINED AND PRESENTED AT THAT TIME. UNINSURED PATIENTS WITH NO MEANS OF PAYMENT ARE ALSO MAILED CHARITY APPLICATIONS AFTER DISCHARGE AND PRIOR TO COLLECTION AGENCY PLACEMENT. COLLECTION AGENCY IS ALSO EDUCATED IN EXPLAINING CHARITY POLICY AND WILL REFER QUALIFYING PATIENT TO HOSPITAL FOR REVIEW. |
| PART VI, LINE 4: NORTHCREST MEDICAL CENTER IS A COMMUNITY, NOT-FOR-PROFIT HOSPITAL LOCATED IN ROBERTSON COUNTY; WHICH IS LOCATED IN NORTHERN MIDDLE TENNESSEE AND INCLUDES EIGHT INDIVIDUAL MUNICIPALITIES. NORTHCREST MEDICAL CENTER IS THE ONLY HOSPITAL LOCATED IN THE COUNTY WITH A POPULATION OF APPROXIMATELY 67,000 CITIZENS. ROBERTSON COUNTY HAS AN AVERAGE HOUSEHOLD INCOME OF $49,000; AND ITS POPULATION IS MADE UP OF 83% CAUCASIAN, 8% AFRICAN-AMERICAN, AND 7% HISPANIC. |
| PART VI, LINE 6: NORTHCREST MEDICAL CENTER IS A NOT-FOR-PROFIT, INDEPENDENT, COMMUNITY HOSPITAL THAT HAS BEEN PROVIDING COMPASSIONATE, QUALITY HEALTHCARE SINCE 1956. WITH A MISSION OF ENHANCING COMMUNITY AND PATIENT WELLNESS, NORTHCREST PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY MEDICAL SERVICES TO NORTHERN MIDDLE TENNESSEE AND SOUTHERN KENTUCKY.NORTHCREST MEDICAL CENTER IS GOVERNED BY A BOARD OF TRUSTEES MADE UP OF LOCAL COMMUNITY-MINDED MEN AND WOMEN. NORTHCREST'S LOCAL BOARD ALLOWS US TO FOCUS ON THE NEEDS OF OUR COMMUNITY AND USE THE MEDICAL CENTER'S RESOURCES TO PROVIDE ADVANCED, HIGH QUALITY CARE IN A CONVENIENT LOCATION FOR OUR CITIZENS AND SUPPORT OUR COMMUNITY'S ORGANIZATIONS AND EVENTS.NORTHCREST'S MEDICAL STAFF IS MADE UP OF HIGHLY TRAINED AND SKILLED PHYSICIANS FROM THROUGHOUT THE WORLD. THE MEDICAL STAFF IS DEDICATED TO SUPPORTING THE MEDICAL CENTER AND ITS MISSION. NORTHCREST IS ALSO LOOKING TO ADD SERVICES AND PHYSICIANS THAT ARE NEEDED FOR THE COMMUNITY. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| NORTHCREST MEDICAL CENTER FOUNDATION | |||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 371723961 | 204224449 | 501 (C) (3) | 117379 | FURTHER EXEMPT PURPOSE OF FOUNDATION BY FUNDING SALARIES OF EMPLOYEES |
| AMERICAN CANCER SOCIETY | |||||||
| 2000 CHARLOTTE AVE | NASHVILLE | TN | 37172 | 131788491 | 501 (C) (3) | 10000 | FURTHER EXEMPT PURPOSE OF AMERICAN CANCER SOCIETY |
| UNITED WAY | |||||||
| 101 FIFTH AVE WEST | SPRINGFIELD | TN | 37172 | 621763845 | 501 (C) (3) | 11667 | FURTHER EXEMPT PURPOSE OF UNITED WAY |
| ROBERTSON COUNTY SCHOOLS | |||||||
| 2121 WOODLAND STREET | SPRINGFIELD | TN | 37172 | 626000810 | GOVERNMENT | 23750 | FURTHER EXEMPT PURPOSE OF ROBERTSON COUNTY SCHOOLS |
| VOLUNTEER STATE COMMUNITY COLLEGE | |||||||
| 1480 NASHVILLE PARK | GALLATIN | TN | 37066 | 581863050 | GOVERNMENT | 20000 | FURTHER EXEMPT PURPOSE OF VOLUNTEER STATE COMMUNITY COLLEGE |
| YMCA OF MIDDLE TENNESSE | |||||||
| 900 CHURCH STREET | NASHVILLE | TN | 37203 | 620476243 | 501 (C) (3) | 9000 | TO FURTHER EXEMPT PURPOSE OF YMCA OF MIDDLE TENNESSEE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 6 | TotalNbrOf501C3AndGovtGrants |
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: NORTHCREST MEDICAL CENTER ONLY PROVIDES FUNDS TO CHARITIES AND QUALIFIED GOVERNMENTAL ENTITIES TO SUPPORT SPECIFIC PROJECTS RELATED TO THE HOSPITAL'S EXEMPT PURPOSES AND THOSE THAT BENEFIT THE COMMUNITY SERVED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Personal Services | X | PersonalServices |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GEORGE DAHIR | |||||||||||||
| 2500 | 441352 | 0 | 0 | 0 | 30176 | 0 | 9808 | 0 | 14092 | 2500 | 495428 | 0 | 0 |
| SCOTT RAYNES | |||||||||||||
| 321775 | 0 | 46000 | 0 | 18352 | 0 | 34188 | 0 | 17620 | 0 | 437935 | 0 | 0 | 0 |
| JIM SCHMIDT | |||||||||||||
| 176540 | 0 | 22000 | 0 | 1090 | 0 | 16359 | 0 | 18231 | 0 | 234220 | 0 | 0 | 0 |
| RANDY MILLS | |||||||||||||
| 168274 | 0 | 21000 | 0 | 1961 | 0 | 16395 | 0 | 11112 | 0 | 218742 | 0 | 0 | 0 |
| ANGELA BEARD | |||||||||||||
| 145898 | 0 | 38744 | 0 | 234 | 0 | 4725 | 0 | 17329 | 0 | 206930 | 0 | 0 | 0 |
| RANDY DAVIS | |||||||||||||
| 132718 | 0 | 19000 | 0 | 179 | 0 | 14645 | 0 | 18434 | 0 | 184976 | 0 | 0 | 0 |
| SHARON JEHLE | |||||||||||||
| 0 | 0 | 0 | 0 | 149026 | 0 | 0 | 0 | 0 | 0 | 149026 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1B | THE DUES, TRAVEL, AND TAX INDEMNIFICATION PAYMENTS ARE APPROVED ON A CASE BY CASE BASIS AT THE DISCRETION OF THE CEO. TRAVEL FOR COMPANIONS AND PERSONAL SERVICES REIMBURSEMENTS ARE NOT SPECIFICALLY LISTED IN THE EXPENSE POLICIES. HOWEVER, THEY BOTH REQUIRE DOCUMENTATION TO BE REIMBURSED AND BOTH ARE INCLUDED IN COMPENSATION IN BOX 1 OF THE W-2 OR 1099-MISC. |
| PART I, LINES 4A-B | SHARON JEHLE RECEIVED $149,026 AS A SEVERANCE PAYMENT, DURING 2010. SEVERAL OFFICERS PARTICIPATED IN A 457(F) PLAN THROUGH THE MEDICAL CENTER. IN 2010, THE FOLLOWING 457(F) AMOUNTS WERE ACCRUED AND ARE RECORDED ON SCHEDULE J AND PART VII, ACCORDINGLY: SCOTT RAYNES: 25,000 JIM SCHMIDT: 10,000 RANDY DAVIS: 10,000 RANDY MILLS: 10,000 AMBER KING: 10,000 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF SPRINGFIELD TN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 521353943 | IssuerEIN |
| CUSIP Number | 85141WAA8 | CUSIPNumber |
| Date Issued | 2010-12-30 | DateIssued |
| Issue Price | 35775000 | IssuePrice |
| Description Of Purpose | FUNDS BEING USED TO RESTRUCTURE DEBT | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 35775000 | TotalProceeds |
| Working Capital Expenditures | 35775000 | WorkingCapitalExpenditures |
| Year Of Subst Completion | 1995 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN KEEGAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 22.080000000000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | AFTER COMPLETION OF FORM 990, NORTHCREST'S ACCOUNTANT PROVIDES THE BOARD WITH A COPY OF THE FORM 990 FOR REVIEW AND IS AVAILABLE TO PRESENT AND EXPLAIN THE FORM 990 AT REQUEST OF BOARD. | |
| THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD AND A CONFLICT DISCLOSURE IS SIGNED. | FORM 990, PART VI, SECTION B, LINE 12C | |
| BOARD REVIEWS DIFFERENT SOURCES, SUCH AS MARKET ANALYSIS, BEFORE APPROVING COMPENSATION OF CEO. CEO THEN IN TURN REVIEWS AND APPROVES COMPENSATION OF KEY EMPLOYEES. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE REQUESTS FOR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS GO THROUGH THE COMPLIANCE OFFICER, AND THE LEGALLY REQUIRED DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 4,149. EQUITY METHOD LOSS - NORTHCREST PHYSICIAN SERVICES -1,716,407. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 514,424. TOTAL TO FORM 990, PART XI, LINE 5: -1,197,834. | FORM 990, PART XI, LINE 5: |
| AUDIT COMMITTEE | THE BOARD OF DIRECTORS HAS A FINANCE COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT. THEIR PROCESSES FOR REVIEW AND SELECTION OF INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XII, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHCREST MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1 |
| City | SPRINGFIELD | City |
| State | TN | State |
| ZIP Code | 372123961 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204224449 | EIN |
| Primary Activities | SUPPORT AND AID IN FINANCING THE EDUCATION OF HEALTH CARE SERVICE PROVIDERS | PrimaryActivities |
| Legal Domicile State | TN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 509(A)(3) | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Share Of Total IncomeShareOfTotalIncome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHCREST STRATEGIC SERVICES INC | ||||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 37172 | 621638556 | OPERATIONS LAB | TN | N/A | C | 11991 | 1.00000 | ||
| NORTHCREST PHYSICIAN SERVICES INC | ||||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 37172 | 621638557 | FAMILY PHYSICIAN | TN | C | 2506232 | 1.00000 | NORTHCREST STRATEGIC SERVICES INC | 9410743 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | 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 | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| NORTHCREST PHYSICIAN SERVICES | ||
| A | 266715 | CASH RECEIVED |
| NORTHCREST MEDICAL CENTER FOUNDATION | ||
| B | 117379 | CASH GIVEN |
| NORTHCREST MEDICAL CENTER FOUNDATION | ||
| C | 32531 | CASH RECEIVED |
| NORTHCREST PHYSICIAN SERVICES | ||
| I | 266715 | CASH GIVEN |
| NORTHCREST PHYSICIAN SERVICES | ||
| K | 228673 | CASH RECEIVED |
| NORTHCREST MEDICAL CENTER FOUNDATION | ||
| K | 7803 | FAIR MARKET VALUE OF SERVICES |
| NORTHCREST MEDICAL CENTER FOUNDATION | ||
| M | 1406 | FAIR MARKET VALUE OF SERVICES |
| NORTHCREST PHYSICIAN SERVICES | ||
| Q | 2467119 | CASH GIVEN |