CENTRAL IOWA HEALTHCARE: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL IOWA HEALTHCARE (EIN 42-0948420)
- Tax period
- 2010-11-01 to 2011-10-31
- Filed
- 2012-06-15
- IRS object ID
- 201241679349300709
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-06-15T08:36:15-05:00 | Timestamp |
| Tax Period End Date | 2011-10-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENMAN & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 22ND STREET SUITE 400 | AddressLine1 |
| City | WEST DES MOINES | City |
| State | IA | State |
| ZIP Code | 50266 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-11-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420948420 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALLTOWN MEDICAL & SURGICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MARS | NameControl |
| Phone | 6417545126 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1 |
| City | MARSHALLTOWN | City |
| State | IA | State |
| ZIP Code | 50158 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN D BURNSIDE | Name |
| Title | CEO/PRESIDENT | Title |
| Phone | 6417545126 | Phone |
| Date Signed | 2012-06-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRUCE CAHILL | Name |
| Phone | 5152258400 | Phone |
| 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 | BRIAN D BURNSIDE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1 |
| City | MARSHALLTOWN | City |
| State | IA | State |
| ZIP Code | 50158 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 62584994 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://WWW.EVERYDAYCHAMPIONS.ORG/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1969 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | TO CREATE AND CONTINUALLY IMPROVE SERVICES THAT RESPOND TO HEALTHCARE NEEDS IN OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 791 | TotalNbrEmployees |
| Total Nbr Volunteers | 325 | TotalNbrVolunteers |
| Total Gross UBI | 90005 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 247242 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 102638 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 60538324 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 58594131 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 85952 | InvestmentIncomePriorYear |
| Investment Income Current Year | 220701 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1913617 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2303565 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 62785135 | TotalRevenuePriorYear |
| Total Revenue Current Year | 61221035 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 36858733 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 35330101 | 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 | 29090037 | OtherExpensePriorYear |
| Other Expenses Current Year | 23787961 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 65948770 | TotalExpensesPriorYear |
| Total Expenses Current Year | 59118062 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3163635 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2102973 | RevenuesLessExpensesCY |
| Total Assets BOY | 65085738 | TotalAssetsBOY |
| Total Assets EOY | 67593035 | TotalAssetsEOY |
| Total Liabilities BOY | 6723117 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7119779 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 58362621 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 60473256 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 50508783 | Expense |
| Revenue | 58594131 | Revenue |
| Description | TO PROVIDE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO MEMBERS OF THE COMMUNITY AND SURROUNDING COMMUNITIES REGARDLESS OF ABILITY TO PAY. CARE INCLUDES PREVENTION, DIAGNOSIS, TREATMENT, REHABILITATION AND OTHER SERVICES. | Description |
| Total Program Service Expense | 50508783 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 100 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 791 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IA | 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 | MARY K PFANTZ | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6417545126 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1 |
| City | MARSHALLTOWN | City |
| State | IA | State |
| ZIP Code | 50158 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| BRIAN D BURNSIDE | |||||||||
| PRESIDENT/CEO | 40.00 | X | X | X | X | 212951 | 0 | 26682 | |
| GREGG SHARP | |||||||||
| CHAIRPERSON | 2.00 | X | X | 0 | 0 | 0 | |||
| TERRENCE BRIGGS MD | |||||||||
| VICE CHAIRPERSON | 2.00 | X | X | 0 | 0 | 0 | |||
| KILEEN REZAC | |||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | |||
| KEITH BLOOMQUIST | |||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | |||
| CAROL HIBBS | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| MIKE MASON | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| NANCY BURK | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| JC POLLPETER | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| LORAS NEUROTH | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| POLLY HINEMAN | |||||||||
| TRUSTEE | 1.00 | X | 52148 | 0 | 4507 | ||||
| JENNIFER MILLER | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| ROBERT L DOWNEY | |||||||||
| CFO | 40.00 | X | 196311 | 0 | 25777 | ||||
| JOHN L MCCUNE | |||||||||
| PHYSICIAN, SURGEON | 40.00 | X | 396660 | 0 | 42818 | ||||
| DARWIN KARR-PETERSON | |||||||||
| PHYSICIAN, SURGEON | 40.00 | X | 381218 | 0 | 31950 | ||||
| RONALD C TERRILL | |||||||||
| PHYSICIAN, INTERNIST | 40.00 | X | 284432 | 0 | 29736 | ||||
| NARASIMHA PALAGUMMI | |||||||||
| PHYSICIAN, INTERNIST | 40.00 | X | 254919 | 0 | 27328 | ||||
| KATHLEEN GRAUERHOLZ | |||||||||
| PHYSICIAN, FAMILY PRACTICE | 40.00 | X | 232966 | 0 | 26230 | ||||
| ROBERT B COOPER | |||||||||
| PRESIDENT/CEO (FORMER) | 338542 | 0 | 27039 | X | |||||
| LARAE SCHELLING | |||||||||
| COO/CNO/INTERIM CEO (FORMER) | 233356 | 0 | 13906 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2583503 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 255973 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | 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 |
|---|---|---|---|---|---|
| MCFARLAND CLINIC PC | |||||
| 1215 DUFF AVENUE | AMES | IA | 50010 | ER PHYSICIAN SERVICES & MISC | 2052684 |
| ARAMARK CORPORATION | |||||
| 12483 COLLECTIONS CENTER | CHICAGO | IL | 60673 | CLINICAL ENGINEERING | 448351 |
| SALAHUDDIN SYED MD PC | |||||
| 1209 IDAHO AVENUE | AMES | IA | 50010 | PATHOLOGY SERVICES | 397500 |
| IOWA HEART CENTER | |||||
| 5880 UNIVERSITY AVE | WEST DES MOINES | IA | 50266 | CARDIOLOGY SERVICES | 331121 |
| ARAMARK HEALTHCARE FOOD | |||||
| PO BOX | CHARLOTTE | NC | 28208 | NUTRITION SERVICES | 287338 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Membership Dues | 11100 | MembershipDues |
| All Other Contributions | 91538 | AllOtherContributions |
| Total Contributions | 102638 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 58594131 | TotalRevenueColumn |
| Related Or Exempt Function Income | 58594131 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 58594131 | TotalProgramServiceRevenue |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 151663 | TotalRevenueColumn |
| Exclusion | $151,663 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1945785 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1171921 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 773864 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 773864 | TotalRevenueColumn |
| Exclusion | $773,864 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6749 | Securities |
| Other | 254327 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 192038 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6749 | Securities |
| Other | 62289 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69038 | TotalRevenueColumn |
| Exclusion | $69,038 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA INCOME | 722210 | 458041 | $458,041 |
| XIX MEANINGFUL USE PAY | 900099 | 366734 | $366,734 |
| HOME HEALTH SUPPORT SE | 621610 | 329357 | $329,357 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 375569 | TotalRevenueColumn |
| Unrelated Business Revenue | 90005 | UnrelatedBusinessRevenue |
| Exclusion | $285,564 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1529701 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 61221035 | TotalRevenueColumn |
| Related Or Exempt Function Income | 58594131 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 90005 | UnrelatedBusinessRevenue |
| Exclusion | $2,434,261 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 578695 | Total |
| Management And General | 578695 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27309069 | Total |
| Program Services | 27309069 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1286342 | Total |
| Program Services | 1057187 | ProgramServices |
| Management And General | 229155 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4292703 | Total |
| Program Services | 3483185 | ProgramServices |
| Management And General | 809518 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1863292 | Total |
| Program Services | 1516676 | ProgramServices |
| Management And General | 346616 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50539 | Total |
| Management And General | 50539 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34000 | Total |
| Management And General | 34000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 460609 | Total |
| Management And General | 460609 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 290637 | Total |
| Management And General | 290637 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 231351 | Total |
| Management And General | 231351 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120454 | Total |
| Program Services | 98563 | ProgramServices |
| Management And General | 21891 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3671802 | Total |
| Program Services | 2761255 | ProgramServices |
| Management And General | 910547 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 506659 | Total |
| Management And General | 506659 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 9184689 | 8453523 | 731166 |
| ER PHYSICIAN PROFESSION | 1720566 | 1720566 | |
| OTHER PHYSICIAN PROFESS | 1153077 | 1153077 | |
| REPAIRS & MAINTENANCE | 1125707 | 779145 | 346562 |
| OTHER ADMINISTRATIVE EX | 1016322 | 1016322 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4221549 | Total |
| Program Services | 2176537 | ProgramServices |
| Management And General | 2045012 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59118062 | Total |
| Program Services | 50508783 | ProgramServices |
| Management And General | 8609279 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39131 | BOY |
| EOY | 14812 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10922475 | BOY |
| EOY | 17059639 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58240 | BOY |
| EOY | 36023 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10320843 | BOY |
| EOY | 10471325 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 776684 | BOY |
| EOY | 569072 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1661703 | BOY |
| EOY | 1651456 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 804980 | BOY |
| EOY | 359758 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 97799794 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 61047495 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39784311 | BOY |
| EOY | 36752299 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 184791 | BOY |
| EOY | 198894 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 149000 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 383580 | BOY |
| EOY | 479757 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65085738 | BOY |
| EOY | 67593035 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5265985 | BOY |
| EOY | 5662647 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1457132 | BOY |
| EOY | 1457132 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6723117 | BOY |
| EOY | 7119779 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58110490 | BOY |
| EOY | 60235320 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 252131 | BOY |
| EOY | 237936 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58362621 | BOY |
| EOY | 60473256 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65085738 | BOY |
| EOY | 67593035 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2102973 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 7662 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | 0 | PoliticalExpenditures |
| Volunteer Hours | 0 | VolunteerHours |
| Amt Of4955 Tax | 0 | AmtOf4955Tax |
| Amt Of4955 Tax On Managers | 0 | AmtOf4955TaxOnManagers |
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $14,769 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 14769 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | MARSHALLTOWN MEDICAL & SURGICAL HAS PAID MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE IOWA HOSPITAL ASSOCIATION. THESE ORGANIZATIONS HAVE PROVIDED AN ESTIMATED PERCENTAGE OF DUES USED FOR LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 640301 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 3375810 | OtherCostOrOtherBasis |
| Book Value | 4016111 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 18403994 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 41193899 | OtherCostOrOtherBasis |
| Depreciation | 32767719 | Depreciation |
| Book Value | 26830174 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 38177 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 32638341 | OtherCostOrOtherBasis |
| Depreciation | 27300473 | Depreciation |
| Book Value | 5376045 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 351451 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1157821 | OtherCostOrOtherBasis |
| Depreciation | 979303 | Depreciation |
| Book Value | 529969 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 36752299 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED 3RD PARTY SETTLEMENT | Description |
| Amount | $1,457,132 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1457132 | TotalOfAmounts |
| Total Revenue | 61221035 | TotalRevenue |
| Total Expenses | 59118062 | TotalExpenses |
| Excess Or Deficit For Year | 2102973 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 7662 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 7662 | TotalAdjustments |
| Excess Or Deficit Per FS | 2110635 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 61124476 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 61124476 | RevenueSubtotal |
| Other Revenues Not Included | 96559 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 96559 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 61221035 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 59029927 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 59029927 | ExpensesSubtotal |
| Other Expenses Not Included | 88135 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 88135 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 59118062 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL FOLLOWS THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX REQUIREMENTS AS REQUIRED BY THE INCOME TAXES TOPIC OF THE FASB ACCOUNTING STANDARDS OF CODIFICATION. THE HOSPITAL HAS EVALUATED THEIR MATERIAL TAX POSITIONS AND DETERMINED NO INCOME TAX EFFECTS WITH RESPECT TO THE FINANCIAL STATEMENTS. THE HOSPITAL'S FEDERAL INCOME TAX RETURNS SINCE 2007 OPEN BY STATUTE ARE SUBJECT TO EXAMINATION BY THE TAX AUTHORITIES. THE HOSPITAL HAS NOT BEEN NOTIFIED OF ANY IMPENDING EXAMINATIONS BY AUTHORITIES, AND NO EXAMINATIONS ARE IN PROCESS. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RESTRICTED INTEREST INCOME 453. MANAGEMENT SERVICES 90,005. RESTRICTED DUES 11,100. RC ADDITIONAL RENTAL EXPENSE -5,000. ROUNDING 1. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT SERVICES 90,005. RESTRICTED EXPENSES 3,130. RC RENTAL EXPENSE -5,000. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 779823 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 779823 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01320 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5735632 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4758784 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 976848 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01650 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6515455 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4758784 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1756671 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02970 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 267819 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 41133 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 226686 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00380 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8881 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8881 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2333589 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1896972 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 436617 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00740 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 35130 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 35130 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2645419 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1938105 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 707314 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01200 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9160874 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6696889 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2463985 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04170 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 52943 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 52943 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 52943 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 52943 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,304,259 | BadDebtExpenseAmount |
| Amount Attributable To | 76174 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 20590416 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 21083422 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -493006 | 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 |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | MARSHALLTOWN MEDICAL & SURGICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVENUE | AddressLine1 |
| City | MARSHALLTOWN | City |
| State | IA | State |
| ZIP Code | 501581928 | 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 | MARSHALLTOWN MEDICAL & SURGICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 6A: A COMMUNITY BENEFIT REPORT IS PREPARED ANNUALLY IN A COLLABORATIVE EFFORT WITH THE IOWA HOSPITAL ASSOCIATION. THIS INFORMATION IS SHARED IN TOTAL FOR THE ENTIRE STATE THROUGH PRESS RELEASES AND FOR OUR INDIVIDUAL HOSPITAL BY INCLUDING THIS INFORMATION IN OUR ANNUAL CORPORATE REPORT, ON OUR WEBSITE AND A LOCAL PRESS RELEASE. | |
| PART I, LINE 7: AMOUNTS REPORTED IN THIS TABLE WERE CALCULATED BASED ON IRS WORKSHEETS 1-8, USING ENTITY SPECIFIC COST TO CHARGE RATIOS. | |
| PART I, LINE 7G: THE AMOUNT REPORTED ON THIS LINE INCLUDES SUBSIDIZED HEALTH SERVICES AT 2 PHYSICIAN CLINICS LOCATED IN 2 SMALL RURAL COMMUNITIES IN OUR GEOGRAPHIC SERVICE AREA. PHYSICIAN CLINICS ARE PROVIDED IN THE SMALL RURAL COMMUNITIES OF TAMA/TOLDEO, AND CONRAD, IOWA TO IMPROVE ACCESS TO HEALTH CARE SERVICES BY REDUCING GEOGRAPHIC AND FINANCIAL BARRIERS. THESE COMMUNITIES WOULD BE MEDICALLY UNDERSERVED IF THESE SERVICES WERE NOT PROVIDED. | |
| PART II: THE COMMUNITY BUILDING ACTIVITIES EXPENSE INCURRED BY MARSHALLTOWN MEDICAL & SURGICAL CENTER ARE EXPENSES INCURRED TO RECRUIT PHYSICIANS WHO WOULD NOT OTHERWISE COME TO THIS MEDICALLY UNDERSERVED AREA AND TO RETAIN PHYSICIANS IN THIS MEDICALLY UNDERSERVED AREA.THE AMOUNT ON LINE 8 IS AN ESTIMATE BASED UPON THE NUMBER OF FINANCIAL ASSISTANCE APPLICATIONS NOT RETURNED AND THE NUMBER OF FINANCIAL ASSISTANCE APPLICATIONS RETURNED WITH INSUFFICIENT DOCUMENTATION. EVERY EFFORT IS MADE TO COLLECT FINANCIAL ASSISTANCE APPLICATIONS AND TO COLLECT ADEQUATE INFORMATION TO MAKE A DETERMINATION OF FINANCIAL ASSISTANCE. | |
| PART III, LINE 4: THE ORGANIZATIONS BAD DEBT EXPENSE (AT COST) IS DETERMINED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO.THE ORGANIZATIONS AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE FOOTNOTE DISCLOSURE REGARDING BAD DEBT, RECEIVABLES OR ALLOWANCES.THIS HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. THE HOSPITAL BILLS THIRD PARTY PAYERS DIRECTLY AND BILLS THE PATIENT ONLY WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENTS ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION, LACK OF PAYMENTS, AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. EVERY EFFORT IS MADE TO MAKE PATIENTS AWARE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. A STATEMENT IS INCLUDED IN THE FIRST BILLING TO PATIENTS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND SIGNS ARE POSTED IN THE REGISTRATION AREAS. THE AMOUNT ON LINE 3 IS AN ESTIMATE BASED UPON THE NUMBER OF FINANCAL ASSISTANCE APPLICATIONS NOT RETURNED AND THE NUMBER OF FINANCIAL ASSISTANCE APPLICATIONS RETURNED WITH INSUFFICIENT DOCUMENTATION. EVERY EFFORT IS MADE TO COLLECT FINANCIAL ASSISTANCE APPLICATIONS AND TO COLLECT ADEQUATE INFORMATION TO MAKE A DETERMINATION OF FINANCIAL ASSISTANCE. | |
| PART III, LINE 8: COSTS WERE DERIVED USING THE MEDICARE COST REPORT.THE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:1) MANY MEDICARE RECIPIENTS ARE LOW-INCOME INDIVIDUALS AND IF NOT FOR MEDICARE, WOULD QUALIFY FOR CHARITY CARE OR OTHER MEANS TESTED GOVERNMENT PROGRAM.2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS.3) IRS REV RULING 69-545 ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR HOSPITALS, WHICH INDICATES, THAT IF A HOSPITAL SERVES PATIENTS COVERED BY GOVERNMENTAL HEALTH BENEFITS (INCLUDING MEDICARE), THEN THIS INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. | |
| PART III, LINE 9B: AFTER A PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS EITHER PARTIALLY OR ENTIRELY WRITTEN-OFF. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. | |
| PART V, SECTION B, LINE 19D: THE HOSPITAL OFFERS A 20% DISCOUNT TO THOSE INDIVIDUALS NOT HAVING INSURANCE AND DON'T MEET THE FINANCIAL ASSISTANCE REQUIREMENTS IF PROMPT PAYMENT IS MADE. | MARSHALLTOWN MEDICAL & SURGICAL CENTER |
| PART V, SECTION B, LINE 21: ALL PATIENTS ARE CHARGED STANDARD PATIENT CHARGES. GROSS CHARGES ARE THE BASIS FOR ALL CHARGES THAT DO NOT INVOLVE A NEGOTIATED INSURANCE DISCOUNT. AFTER A BILL HAS BEEN PROCESSED BY INSURANCE, THE INDIVIDUAL IS BILLED FOR CO-PAYS AND DEDUCTIBLES, AND NON-COVERED SERVICES. ONLY THOSE PATIENTS WHO FAIL TO RESPOND TO THE PROMPT PAY 20% DISCOUNT ARE SUBJECT TO PAYING FULL CHARGES. | MARSHALLTOWN MEDICAL & SURGICAL CENTER |
| PART VI, LINE 2: MARSHALLTOWN MEDICAL & SURGICAL CENTER AND THE MARSHALL COUNTY BOARD OF HEALTH AND THE PIONEERING HEALTHIER COMMUNITY COALITION PARTNERED TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN 2009-2010. THROUGH THESE EFFORTS PRIORITIES AND STRATEGIES HAVE BEEN DEVELOPED. REPRESENTATIVES OF MARSHALLTOWN MEDICAL & SURGICAL CENTER ARE INVLOVED IN THE ABOVE MENTIONED GROUPS AND THE LARGER COALITION.THE HEALTH NEEDS OF THE COMMUNITY ARE ASSESSED THROUGH A COMMUNITY NEEDS ASSESSMENTS PROCESS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY, AND TO ASSIST OUR COMMUNITY PARTNERS IN FOCUSING ON OUR COMMUNITIES FURTURE HEALTH NEEDS. THIS ASSESSMENT SERVES AS THE BASIS FOR MARSHALL COUNTY PUBLIC HEALTH, PIONEERING HEALTHIER COMMUNITIES, AND OUR OVERALL HEALTHCARE COMMUNITY TO DEVELOP ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THIS COMMUNITY NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHT INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED- IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGMARSHALLTOWN MEDICAL & SURGICAL CENTER ACTIVELY CONTRIBUTES TO THE COMMUNITY NEEDS ASSESSMENT AND ENGAGES IN THE PRIORITIES THAT MATCH ITS VISION AND MISSION. MEASUREMENT AND EVALUATION TOOLS ARE COLLECTED AND MONITORED BY THE LARGER COMMUNITY COALITION ENGAGED IN THE VARIOUS EFFORTS.IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, MARSHALLTOWN MEDICAL & SURGICAL CENTER MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND RESOURCES AVAILABLE. INDIVIDUAL DEPARTMENTS ALSO WORK TO IDENTIFY COMMUNITY NEEDS AS RELATED TO THEIR SERVICES AND THE POPULATION SERVED. | |
| PART VI, LINE 3: SIGNS STATING THAT FINANCIAL ASSISTANCE AND FREE CARE ARE AVAILABLE ARE POSTED IN THE HOSPITAL REGISTRATION AND CASHIER AREAS. REGISTRATION STAFF HAVE EDUCATIONAL MATERIAL AND APPLICATION FORMS THAT ARE MADE AVAILABLE TO PATIENTS WANTING INFORMATION OR AN APPLICATION FOR OUR COMMUNITY ASSITANCE PROGRAM. PATIENT FINANCIAL SERVICE REPS CONSULT AND ADVISE SELF PAY PATIENTS ON THEIR OPTIONS FOR GOVERNMENT SPONSORED FINANCIAL ASSISTANCE AS WELL AS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM.ADDITIONALLY, AN OUTSIDE VENDOR CONTACTS ADMITTED SELF PAY PATIENTS AND DISCUSSES OPTIONS FOR GOVERNMENT SPONSORED FINANCIAL ASSISTANCE AND PROVIDES ASSISTANCE TO PATIENTS APPLYING FOR A SPECIFIC PROGRAM. OUR OUTSIDE VENDOR DIRECTS PATIENTS THAT DO NOT QUALIFY FOR A GOVERNMENT SPONSORED PROGRAM TO A HOSPITAL FINANCIAL SERVICE REP. TO FOLLOW UP WITH AN APPLICATION FOR COMMUNITY ASSISTANCE. WE FURTHER USE AN "EARLY OUT" SELF PAY VENDOR THAT PROVIDES INFORMATION ON GOVERNMENT PROGRAMS AND THE HOSPITAL'S COMMUNITY ASSISTANCE PROGRAM. OUR SELF PAY VENDOR PROVIDES COMMUNITY ASSISTANCE APPLICATIONS TO PATIENTS WHEN AN APPLICATION IS REQUESTED AND MAKES REFERRALS FOR POSSIBLE APPLICATION TO GOVERNMENT SPONSORED ASSISTANCE PROGRAMS. ALSO, A STATEMENT IS INCLUDED IN THE FIRST BILLING TO PATIENTS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. | |
| PART VI, LINE 4: MARSHALL COUNTY, POPULATION 40,648, IS COMPRISED OF 13 INCORPORATED COMMUNITIES AND THEIR SURROUNDING AREAS. THE POPULATION IS SOMEWHAT CONCENTRATED IN THE CENTRAL CITY OF MARSHALLTOWN WHERE ABOUT 66% OF COUNTY RESIDENTS LIVE. THE COUNTY'S POPULATION HAS REMAINED STABLE OVER THE PAST 50 YEARS; HOWEVER, THE DEMOGRAPHICS OF THE POPULATION HAVE SHIFTED DRAMATICALLY IN THE PAST 15 YEARS. NEW IMMIGRANTS RECRUITED TO THE COMMUNITY BY THE MEAT PACKING INDUSTRY HAVE DRIVEN THESE CHANGES. LARGE NUMBERS OF HISPANIC IMMIGRANTS HAVE LEFT THE SUB-MINIMUM WAGE EXISTENCE IN CENTRAL MEXICO TO TRAVEL TO THE AMERICAN MIDWEST FOR JOBS IN MEAT PACKING. THIS INDUSTRY IS THE LARGEST PRIVATE EMPLOYER IN MARSHALL COUNTY WITH PAY RANGING FROM $9-13 PER HOUR.THESE CHANGES HAVE RESULTED IN AN INCREASE IN THE NUMBER OF PEOPLE LIVING IN POVERTY AND AN UPSURGE IN THE NUMBER OF UNINSURED OR UNDERINSURED RESIDENTS. MARSHALL COUNTY IS DESIGNATED AS A HEALTH PROVIDER SHORTAGE AREA (HPSA). FURTHER, THE COUNTY HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED COMMUNITY (MUC) AND THE IMMIGRANT POPULATION HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED POPULATION (MUP) DUE TO LANGUAGE AND CULTURAL BARRIERS IN ACCESSING HEALTH CARE SERVICES.ACCORDING TO THE 2010 U.S. CENSUS DATA: 17.3% OF THE MARSHALL COUNTY'S POPULATION IS OF HISPANIC OR LATINO ORIGIN COMPARED TO 5.0% IN THE STATE OF IOWA; 16.3% OF MARSHALL COUNTY'S POPULATION (AGE 5+) SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME COMPARED TO 6.8% IN THE STATE OF IOWA (2000 CENSUS); 85.7% OF MARSHALL COUNTY RESIDENTS ARE HIGH SCHOOL GRADUATES COMPARED TO 89.9% IN IOWA (2000); 18.7% OF MARSHALL COUNTY POPULATION HAD A BACHELOR'S DEGREE OR HIGHER COMPARED TO 24.5% IN IOWA (2000); THE MEDIAN HOUSEHOLD INCOME IN 2004 IN MARSHALL COUNTY WAS $45,232 COMPARED TO $48,872 IN IOWA; PERSONS LIVING BELOW POVERTY IN MARSHALL COUNTY WAS 12.7% COMPARED TO 11.6% IN IOWA. | |
| PART VI, LINE 6: MARSHALLTOWN MEDICAL & SURGICAL CENTER IS A SOLE COMMUNITY HOSPITAL AND A RURAL REFERRAL CENTER BY CMS'S DEFINITIONS. THE HOSPITAL IS LOCATED IN A RURAL, MEDICALLY UNDERSERVED AREA AND IS THE ONLY HOSPITAL WITHIN A 30 MILE RADIUS. THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES AND CONTINUALLY IMPROVING SERVICES TO RESPOND TO HEALTH CARE NEEDS. THE HOSPITAL PROVIDES A 24 HOUR EMERGENCY DEPARTMENT, INCLUDING AMBULANCE COVERAGE, AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY.A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES, NOR CONTRACTORS, NOR FAMILY MEMBERS THEREOF AND ARE A BROAD CROSS SECTION OF COMMUNITY LEADERS. THE ORGANIZATION PROVIDES AN OPEN MEDICAL STAFF TO ALL QUALIFIED PHYSICIANS, SUBJECT TO THE NORMAL, EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, EMERGENCY DEPARTMENT, AND HEART CATHETERIZATION LAB. THE EXCLUSIVE CONTRACTS ARE NECESSARY TO ASSURE THAT THESE MUCH NEEDED SERVICES ARE PROVIDED IN THIS RURAL MEDICALLY UNDERSERVED COMMUNITY.ALL SURPLUS FUNDS ARE USED TO MEET AND TO RESPOND TO THE HEALTHCARE NEEDS OF THE COMMUNITIES THIS ORGANIZATION SERVES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRIAN D BURNSIDE | |||||||||||||
| 209995 | 0 | 0 | 0 | 2956 | 0 | 10821 | 0 | 15861 | 0 | 239633 | 0 | 0 | 0 |
| ROBERT L DOWNEY | |||||||||||||
| 188038 | 0 | 0 | 0 | 8273 | 0 | 10048 | 0 | 15729 | 0 | 222088 | 0 | 0 | 0 |
| JOHN L MCCUNE | |||||||||||||
| 395112 | 0 | 0 | 0 | 1548 | 0 | 20078 | 0 | 22740 | 0 | 439478 | 0 | 0 | 0 |
| DARWIN KARR-PETERSON | |||||||||||||
| 196497 | 0 | 0 | 0 | 184721 | 0 | 19184 | 0 | 12766 | 0 | 413168 | 0 | 0 | 0 |
| RONALD C TERRILL | |||||||||||||
| 235468 | 0 | 0 | 0 | 48964 | 0 | 14413 | 0 | 15323 | 0 | 314168 | 0 | 0 | 0 |
| NARASIMHA PALAGUMMI | |||||||||||||
| 196932 | 0 | 0 | 0 | 57987 | 0 | 12900 | 0 | 14428 | 0 | 282247 | 0 | 0 | 0 |
| KATHLEEN GRAUERHOLZ | |||||||||||||
| 196932 | 0 | 0 | 0 | 36034 | 0 | 11802 | 0 | 14428 | 0 | 259196 | 0 | 0 | 0 |
| ROBERT B COOPER | |||||||||||||
| 43614 | 0 | 0 | 0 | 294928 | 0 | 5395 | 0 | 21644 | 0 | 365581 | 0 | 0 | 0 |
| LARAE SCHELLING | |||||||||||||
| 88421 | 0 | 0 | 0 | 144935 | 0 | 5566 | 0 | 8340 | 0 | 247262 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|
| NARASIMHA PALAGUMMI | |||||
| X | $110,000 | 22000 | 0 | 1 | 1 |
| KATHLEEN GRAUERHOLZ | |||||
| X | $150,000 | 60000 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 82000 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN MCCARVILLE MD - 50 OWNER OF | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FORMER BOARD MEMBER | Relationship |
| Amount Of Transaction | 100000 | AmountOfTransaction |
| Description Of Transaction | PAYMENT TO PROVIDE OBSTETRICS/GYNECOLOGY CARE TO THE UNINSURED OR UNDERINSURED WOMEN IN THE HOSPITAL'S SERVICE AREA. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCH L, PART II, LOANS TO AND/OR FROM INTERESTED PERSONS: | Identifier |
| Explanation | IN AN EFFORT TO RECRUIT AND RETAIN PHYSICIANS TO PRACTICE MEDICINE IN THIS RURAL, MEDICALLY UNDERSERVED AREA, IT HAS BECOME NECESSARY TO OFFER INCENTIVES TO PHYSICIANS. ONE SUCH INCENTIVE IS A FORGIVABLE LOAN. THIS LOAN IS GIVEN TO A PHYSICIAN AS AN INCENTIVE TO ESTABLISH A PRACTICE AND IS FORGIVEN OVER A PERIOD OF YEARS AS AN INCENTIVE TO MAINTAIN PRACTICE. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS IN THIS ENTITY SHALL BE BONA FIDE CITIZENS OF THE AREA SERVED BY THIS HOSPITAL WHO ARE AT LEAST 18 YEARS OF AGE AND WHO HAVE PAID THEIR ANNUAL DUES. | |
| FORM 990, PART VI, SECTION A, LINE 7A | AN ANNUAL MEETING IS HELD IN WHICH THE AGENDA INCLUDES ELECTION OF TRUSTEES. PROXY VOTES MAY BE CAST BY ELIGIBLE MEMBERS WHO ARE UNABLE TO ATTEND THE MEETING. THE BOARD MEMBERSHIP SHALL INCLUDE MEMBERS FROM THE COMMUNITIES THAT ARE SERVED BY MARSHALLTOWN MEDICAL & SURGICAL CENTER. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 AND ALL RELATED SCHEDULES AND SUPPLEMENTAL INFORMATION WERE MAILED TO ALL BOARD MEMBERS PRIOR TO FILING. ALL BOARD MEMBER INQUIRIES WERE RESOLVED PRIOR TO FILING. | |
| THE CONFLICT OF INTEREST POLICY REQUIRES ANNUAL CERTIFICATION THAT EACH TRUSTEE HAS THE CONFLICT OF INTEREST POLICY, THAT THEY HAVE A COPY OF THE SECTION OF THE ORGANIZATIONAL BY-LAWS THAT DISCUSS CONFLICTS OF INTEREST, AND THAT THEY AGREE TO COMPLY WITH THE POLICY. THE EXECUTIVE ASSISTANT TO THE PRESIDENT IS ASSIGNED TO ASSURE THAT ALL RECIPIENTS ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS WHO MEET MULTIPLE TIMES PER YEAR TO REVIEW THE IOWA HOSPITAL ASSOCIATION'S WAGE SURVEY DATA. THE COMMITTEE RECOMMENDS CHANGES BASED ON SURVEY COMPARISONS AND ANNUAL PERFORMANCE EVALUATIONS. THE RECOMMENDATIONS ARE PRESENTED TO THE FULL BOARD. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION'S 990 AND 990-T ARE AVAILABLE ON GUIDESTAR.COM AS WELL AS UPON REQUEST. THE ORGANIZATION'S FORM 1023 IS AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 18 | |
| THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 7,662. | FORM 990, PART XI, LINE 5: |
| THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE AUDITORS MEET WITH THE COMMITTEE PRIOR TO THE AUDIT AND THE AUDITORS MAKE A PRESENTATION OF THEIR FINDINGS TO THE FULL BOARD. | FORM 990, PART XI, LINE 2(C): | |
| GENERAL INFORMATION: | MARSHALLTOWN MEDICAL & SURGICAL CENTER IS A SOLE COMMUNITY HOSPITAL AND A RURAL REFERRAL CENTER BY CMS'S DEFINITION. THE HOSPITAL IS LOCATED IN A RURAL, MEDICALLY UNDER SERVED AREA AND IS THE ONLY HOSPITAL WITHIN A 30 MILE RADIUS. THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES AND CONTINUALLY IMPROVING SERVICES TO RESPOND TO THE HEALTHCARE NEEDS OF THE COMMUNITIES. MARSHALLTOWN MEDICAL & SURGICAL CENTER SUPPORTS THIS MISSION WITH A COMMUNITY BOARD AND 24 HOUR EMERGENCY DEPARTMENT AVAILABLE TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. CHARITY CARE IS PROVIDED TO PATIENTS WITH A DEOMONSTRATED INABILITY TO PAY. MARSHALLTOWN MEDICAL & SURGICAL CENTER HAS A CHARITY CARE POLICY, USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR CHARITY, ANNUALLY BUDGETS FOR CHARITY CARE AND THE ANNUAL AMOUNT OF CHARITY CARE PROVIDED EXCEEDS THE BUDGETED AMOUNT. | |
| IN AN EFFORT TO RECRUIT AND RETAIN PHYSICIANS TO PRACTICE MEDICINE IN THIS RURAL, MEDICALLY UNDERSERVED AREA IT HAS BECOME NECESSARY TO OFFER INCENTIVES TO PHYSICIANS. ONE SUCH INCENTIVE IS A FORGIVABLE LOAN. THIS LOAN IS GIVEN TO PHYSICIANS AS AN INCENTIVE TO ESTABLISH A PRACTICE AND IT IS FORGIVEN OVER A PERIOD OF YEARS AS AN INCENTIVE TO MAINTAIN A PRACTICE. | FORM 990, SCHEDULE L, PART II: |