MINNIE HAMILTON HEALTH CARE CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MINNIE HAMILTON HEALTH CARE CENTER (EIN 55-0629032)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-14
- IRS object ID
- 201123189349304732
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-14T13:42:05-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett & Foster PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1 |
| City | Charleston | City |
| State | WV | State |
| ZIP Code | 25329 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550629032 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Minnie Hamilton Health Care Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MINN | NameControl |
| Phone | 3043549244 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Randy Lindauer | Name |
| Title | CEO | Title |
| Phone | 3043549244 | Phone |
| Date Signed | 2011-11-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Harry C Harless | Name |
| Phone | 3043460441 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Minnie Hamilton Health System | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Randy Lindauer | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16574617 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mhhcc.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | The organization operates a critical access hospital, community health center, federal qualified health center, and long-term care unit. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 294 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2051730 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1936882 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 13778338 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 14478148 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4350 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2853 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 166772 | OtherRevenuePriorYear |
| Other Revenue Current Year | 156734 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16001190 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16574617 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 57319 | 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 | 10029063 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10291100 | 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 | 5813081 | OtherExpensePriorYear |
| Other Expenses Current Year | 5950581 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15899463 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16241681 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 101727 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 332936 | RevenuesLessExpensesCY |
| Total Assets BOY | 6070880 | TotalAssetsBOY |
| Total Assets EOY | 6713748 | TotalAssetsEOY |
| Total Liabilities BOY | 3153786 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3463718 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2917094 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3250030 | NetAssetsOrFundBalancesEOY |
| Mission Description | Minnie Hamilton Health System is dedicated to maintaining the health and improving the quality of life of all people in our service area through an innovative delivery system of services and education. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 13967276 | Expense |
| Revenue | 14468313 | Revenue |
| Description | Inpatient services provided included 1,107 acute care days, 8,278 long term care days and 924 swing bed days. Outpatient services included 16,972 outpatient visits and 1,733 emergency room visits. Primary care services include 36,759 clinic visits and 2,934 dental clinic visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9081 | Expense |
| Revenue | 9835 | Revenue |
| Description | A total of 203 mammography procedures were performed during the year. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 13976357 | 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 | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | 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 | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | 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 | 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 | 8 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 294 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | 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
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stephen J Whited | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3043549244 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 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 |
|---|---|---|---|---|---|---|---|
| Jean Simers | |||||||
| President | 2.00 | X | 0 | 0 | 0 | ||
| Randy Ball | |||||||
| Vice President | 2.00 | X | 0 | 0 | 0 | ||
| Reta Kight | |||||||
| Treasurer | 2.00 | X | 0 | 0 | 0 | ||
| Kathy Frederick | |||||||
| Secretary | 2.00 | X | 0 | 0 | 0 | ||
| John Oshoway | |||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||
| Neal Benson | |||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||
| Ronald Blankenship | |||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||
| Harold Carpenter | |||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||
| Barbara W Lay | |||||||
| CEO | 40.00 | 148818 | 0 | 265 | X | ||
| Stephen S Whited | |||||||
| COO/CFO | 40.00 | 112801 | 0 | 635 | X | ||
| Alfonso P Cinco | |||||||
| Physician | 56.00 | 392776 | 0 | 8522 | X | ||
| Suresh Balasubramony | |||||||
| Physician | 41.00 | 318437 | 0 | 7998 | X | ||
| Autumn Whitlock-Morales | |||||||
| Physician | 45.00 | 317914 | 0 | 5763 | X | ||
| Vish Hande | |||||||
| Physician | 26.00 | 200795 | 0 | 5142 | X | ||
| Rudolph Kevak | |||||||
| Physician | 26.00 | 193091 | 0 | 1947 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1684632 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 30272 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Nextgen | |||||
| PO Box 809390 | Chicago | IL | 60680 | Computer Operating Systems | 402561 |
| Radiological Physician Associates | |||||
| 70 Village Drive | Fairmont | WV | 26554 | Radiological Professional Services | 218917 |
| CPSI | |||||
| 600 Wall Street | Mobile | AL | 36695 | Computer Operating Systems | 197691 |
| Coast to Coast | |||||
| 5195 Hampstead Village Center | New Albany | OH | 43054 | ER Professional Services | 175648 |
| Labcorp of America | |||||
| 231 Maple Ave | Burlington | NC | 27216 | Reference Lab | 122448 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 1910891 | GovernmentGrants |
| All Other Contributions | 25991 | AllOtherContributions |
| Total Contributions | 1936882 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient services | 622110 | 14309910 | 14309910 |
| Other health care | 622110 | 168238 | 168238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 14478148 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2853 | TotalRevenueColumn |
| Exclusion | $2,853 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 15002 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 15002 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15002 | TotalRevenueColumn |
| Exclusion | $15,002 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria Income | 722210 | 71905 | $71,905 |
| Day Care | 624410 | 54759 | $54,759 |
| Rebate/refund income | 900099 | 14123 | $14,123 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 945 | TotalRevenueColumn |
| Exclusion | $945 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 141732 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16574617 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14478148 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $159,587 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262576 | Total |
| Program Services | 225316 | ProgramServices |
| Management And General | 37260 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8749684 | Total |
| Program Services | 7508104 | ProgramServices |
| Management And General | 1241580 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 653481 | Total |
| Program Services | 560752 | ProgramServices |
| Management And General | 92729 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 625359 | Total |
| Program Services | 536621 | ProgramServices |
| Management And General | 88738 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16481 | Total |
| Management And General | 16481 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87258 | Total |
| Management And General | 87258 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 985421 | Total |
| Program Services | 985421 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36379 | Total |
| Program Services | 31217 | ProgramServices |
| Management And General | 5162 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1393863 | Total |
| Program Services | 1196074 | ProgramServices |
| Management And General | 197789 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 443092 | Total |
| Program Services | 380217 | ProgramServices |
| Management And General | 62875 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88984 | Total |
| Program Services | 76357 | ProgramServices |
| Management And General | 12627 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124464 | Total |
| Management And General | 124464 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 711945 | Total |
| Program Services | 610920 | ProgramServices |
| Management And General | 101025 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 146460 | Total |
| Management And General | 146460 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 1320232 | 1320232 | |
| Health care provider ta | 237930 | 237930 | |
| Repairs & Maintenance | 116567 | 100026 | 16541 |
| WV Use tax | 89296 | 76625 | 12671 |
| Dues & licenses | 65573 | 56268 | 9305 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86636 | Total |
| Program Services | 74277 | ProgramServices |
| Management And General | 12359 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16241681 | Total |
| Program Services | 13976357 | ProgramServices |
| Management And General | 2265324 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4779 | BOY |
| EOY | 4624 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 754841 | BOY |
| EOY | 660963 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42634 | BOY |
| EOY | 25257 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1717821 | BOY |
| EOY | 2322993 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117496 | BOY |
| EOY | 121204 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60925 | BOY |
| EOY | 43067 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8087630 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4551990 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3372384 | BOY |
| EOY | 3535640 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6070880 | BOY |
| EOY | 6713748 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 841805 | BOY |
| EOY | 1175150 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39580 | BOY |
| EOY | 29845 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1784627 | BOY |
| EOY | 1555957 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 153825 | BOY |
| EOY | 130930 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 333949 | BOY |
| EOY | 571836 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3153786 | BOY |
| EOY | 3463718 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2917094 | BOY |
| EOY | 3250030 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2917094 | BOY |
| EOY | 3250030 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6070880 | BOY |
| EOY | 6713748 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 332936 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| 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 | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
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
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2286173 | OtherCostOrOtherBasis |
| Depreciation | 941388 | Depreciation |
| Book Value | 1344785 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 473615 | OtherCostOrOtherBasis |
| Depreciation | 80641 | Depreciation |
| Book Value | 392974 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5327842 | OtherCostOrOtherBasis |
| Depreciation | 3529961 | Depreciation |
| Book Value | 1797881 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3535640 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital leases | $447,378 |
| Estimated Third Party Payor Settlements | $124,458 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 571836 | TotalOfAmounts |
| Total Revenue | 16574617 | TotalRevenue |
| Total Expenses | 16241681 | TotalExpenses |
| Excess Or Deficit For Year | 332936 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 332936 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 16580889 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 6272 | OtherRevenues |
| Revenue Not Rptd F990 | 6272 | RevenueNotRptdF990 |
| Revenue Subtotal | 16574617 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 16574617 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 16247953 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 6272 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 6272 | ExpensesNotRptdF990 |
| Expenses Subtotal | 16241681 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 16241681 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XII, Line 2d - Other Adjustments: | Loss on disposal of assets netted with expenses in financial statements 6,272. |
| Part XIII, Line 2d - Other Adjustments: | Loss on disposal of assets netted with expenses in financial statements 6,272. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| 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 | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 623108 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 545240 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 77868 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1044251 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 951225 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 93026 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00620 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1667359 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1496465 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 170894 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01140 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 14 | NumberOfActivitiesOrPrograms |
| Persons Served | 600 | PersonsServed |
| Total Community Benefit Expense | 83512 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 80512 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 14 | NumberOfActivitiesOrPrograms |
| Persons Served | 600 | PersonsServed |
| Total Community Benefit Expense | 83512 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 80512 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 14 | NumberOfActivitiesOrPrograms |
| Persons Served | 600 | PersonsServed |
| Total Community Benefit Expense | 1750871 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1576977 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 173894 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01160 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,332,770 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 3313712 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3269312 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 44400 | 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 | Minnie Hamilton Health Care Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | Long Term Care | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Minnie Hamilton Health Care Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| 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 |
| Medicare Rate | X | MedicareRate |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 3c: 1. The qualifications for the Sliding Fee Program are based on both the number of people in the household and the total gross income received in the household. 2. The applicants are required to complete the Sliding Fee Program application and to provide a proof of income within 30 days after filing their application. Acceptable proof of income includes: wage statement, W-2 forms, check stub, retirement statement, unemployment statement, social security check or benefit letter, alimony check, child support check, food stamp voucher, or other documents approved by financial management.3. If the patient has no income, they are asked to declare so by signing a Lack of Income Verification form. 4. The Financial Assistance Application, along with the above mentioned documents verifying income or lack of it, will be processed promptly by the cashier/clerk.5. After the patient has been approved for the Sliding Fee Program, they will receive a Sliding Fee identification card describing the benefits such as: A. Fee of $5 or $10 for an office visit, collected at the time of the visit B. 40% or 50% discount for lab tests C. 40% to 50% discount for the technical component of diagnostic, non-invasive radiology services D. 40 to 50% discount on respiratory procedures6. Qualification for Sliding Fee remains in effect for one year from the date of approval, unless the patient or the household income should change within that year.7. The Sliding Fee Program benefits may apply to the outstanding patient accounts which do not exceed 365 days from the day of service. Accounts which have already been sent to a collection agency may not qualify for this program. 8. It is the patient's responsibility to reapply annually for continued participation in the Sliding Fee Program. | |
| 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 $ 1320232. | |
| Part III, Line 8: Medicare Cost Report | |
| Part III, Line 9b: Patients who complete an application and qualify for account exoneration or a sliding fee, will have accounts classified as charity care. | |
| Part V, Section B, Line 11h: Patients are charged the amount via the item master and discounted according to policy and income guideline levels. | Minnie Hamilton Health Care Center, Inc. |
| Part V, Section B, Line 15e: Utilized collection agencies as well as magistrate court. | Minnie Hamilton Health Care Center, Inc. |
| Part V, Section B, Line 17e: Utilized collection agencies as well as magistrate court. | Minnie Hamilton Health Care Center, Inc. |
| Part V, Section B, Line 19d: Patients are charged the amount via the item master and discounted according to policy and income guideline levels. | Minnie Hamilton Health Care Center, Inc. |
| Part 1, Line 7, Additional Information: The Organization's charity care policy outlines the purpose, guidelines and qualifications for charity care. Some of the qualifications include: a family income within the Federal Poverty Guidelines, exceptions where economic assets and total income are considered, and consideration of undue hardship. The Organization's sliding fee policy is similar with procedures and percentage amounts clearly written down. The sliding fee policy applies when a patient is uninsured, underinsured or insured with a deductible or co-pay and meets the Federal Income Poverty Guidelines but does not qualify for Medicaid. | |
| Part VI, Line 2: Records of types of visits and diagnosis are kept and analyzed for adjustment of appropriate services. Official community needs assessments are periodically performed by an outside agency. | |
| Part VI, Line 3: The organization's charity care policy outlines the purpose, guidelines and qualifications for charity care. Some of the qualifications include: a family income within the Federal Poverty guidelines, exceptions where economic assets and total income are considered, and consideration of undue hardship. The Organization's sliding fee policy is similar with procedures and percentage amounts clearly written down. The sliding fee policy applies when a patient is uninsured, underinsured or insured with a deductible or co-pay and meets the Federal Income Poverty guidelines but does not qualify for Medicaid. | |
| Part VI, Line 4: The organization services a rural area of 16,000 people in Calhoun, Gilmer and surrounding counties. The county has one of the highest unemployment rates in the State of WV. Patient principal payers percentages are: 38% medicare, 19% medicaid, 17% commercial, and 26% private pay. The nearest Hospital is over 30 miles away. The Health Care Center is designated as an HPSA site. | |
| Part VI, Line 6: All board members reside in the service area and none are employed by, or have contractual arrangements with Minnie Hamilton Health Care Center. The medical staff privileges are available to all qualified providers in the area. All profit and available funding is utilized for continuation and improvement of the provision of appropriate health services through staffing and acquisition of equipment and supplies. A 24-hour emergency room doctor is provided regardless of a patient's ability to pay. The nearest hospital is 40 minutes away, by car. An active auxiliary is made up of local volunteers and has been present during all years of the facilities hospital services. |
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 | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alfonso P Cinco | |||||||||||||
| 392776 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 8551 | 0 | 401327 | 0 | 0 | 0 |
| Suresh Balasubramony | |||||||||||||
| 318437 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 8026 | 0 | 326463 | 0 | 0 | 0 |
| Autumn Whitlock-Morales | |||||||||||||
| 317914 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5792 | 0 | 323706 | 0 | 0 | 0 |
| Vish Hande | |||||||||||||
| 200795 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5161 | 0 | 205956 | 0 | 0 | 0 |
| Rudolph Kevak | |||||||||||||
| 193091 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1947 | 0 | 195038 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Calhoun County Building Commission | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 556000308 | IssuerEIN |
| Date Issued | 2006-12-13 | DateIssued |
| Issue Price | 2455000 | IssuePrice |
| Description Of Purpose | Refinance existing debt and new capital expenditures | 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 | 2455000 | TotalProceeds |
| Working Capital Expenditures | 955614 | WorkingCapitalExpenditures |
| Capital Expenditures | 1499386 | CapitalExpenditures |
| Year Of Subst Completion | 2007 | YearOfSubstCompletion |
| Current Refunding | 0 | 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 |
| 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 | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by Senior Management, the Finance Committee and the Board of Directors. | |
| The Board of Directors sign the statement annually. Individual members are excused from decision making on issues where conflicts my arise. A Board of Director member recuses themself from voting on issues where a conflict may exist. | Form 990, Part VI, Section B, line 12c | |
| A survey of alike facilities in the state, utilizing the Health Care Authority information that is available, to compare salaries of top executives, as well as looking at job responsibilities and years of experience. The CEO is a contracted position and approved by the Board of Directors. Senior management is approved by the CEO. | Form 990, Part VI, Section B, line 15 | |
| Audited Financial Statements are available upon request to the public. Annually the audited balance sheet and income statement are published in the local newspaper as per the Health Care Authority financial disclosure requirements. | Form 990, Part VI, Section C, line 19 | |
| Volunteers | Volunteers of the organization include members of the hospital auxiliary and teenagers involved in a volunteer program. | Form 990, Page 1, Line 6 |