CUMBERLAND MEDICAL CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: CUMBERLAND MEDICAL CENTER INC (EIN 62-0790132)
Tax period: 2009-07-01 to 2010-06-30
Filed: 2011-05-05
IRS object ID: 201131259349300503
Schema version: 2009v1.7
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-05-05T07:29:12-05:00	Timestamp
Tax Period End Date	2010-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHNSON HICKEY & MURCHISON PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	651 E 4TH ST STE 200	AddressLine1
City	CHATTANOOGA	City
State	TN	State
ZIP Code	37403	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	620790132	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CUMBERLAND MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CUMB	NameControl
Phone	9314849511	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	421 SOUTH MAIN STREET	AddressLine1
City	CROSSVILLE	City
State	TN	State
ZIP Code	38555	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	LARRY MOORE	Name
Title	CFO	Title
Phone	9314849511	Phone
Date Signed	2011-02-10	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JOEL D SUSMAN	Name
Phone	4237560052	Phone
Date Prepared	2011-05-05	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	LARRY MOORE CFO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	421 SOUTH MAIN STREET	AddressLine1
City	CROSSVILLE	City
State	TN	State
ZIP Code	38555	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	103084194	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	WWW.CMCHEALTHCARE.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1967	YearFormation
State Legal Domicile	TN	StateLegalDomicile
Activity Or Mission Description	TO MAKE QUALITY HEALTH CARE AVAILABLE ON A REGIONAL LEVEL TO THOSE IN NEED OF OUR SERVICE THROUGH DEDICATION, PROFESSIONALISM AND CHARITABLE ENDEAVORS WHILE MAINTAINING FINANCIAL STABILITY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	1278	TotalNbrEmployees
Total Nbr Volunteers	163	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	264249	ContributionsGrantsPriorYear
Contributions Grants Current Year	58233	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	104352469	ProgramServiceRevenuePriorYear
Program Service Revenue CY	101663219	ProgramServiceRevenueCY
Investment Income Prior Year	924652	InvestmentIncomePriorYear
Investment Income Current Year	665003	InvestmentIncomeCurrentYear
Other Revenue Prior Year	481927	OtherRevenuePriorYear
Other Revenue Current Year	532739	OtherRevenueCurrentYear
Total Revenue Prior Year	106023297	TotalRevenuePriorYear
Total Revenue Current Year	102919194	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	54980876	SalariesEtcPriorYear
Salaries Etc Current Year	54721484	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	51274118	OtherExpensePriorYear
Other Expenses Current Year	48972362	OtherExpensesCurrentYear
Total Expenses Prior Year	106254994	TotalExpensesPriorYear
Total Expenses Current Year	103693846	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-231697	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-774652	RevenuesLessExpensesCY
Total Assets BOY	129628808	TotalAssetsBOY
Total Assets EOY	126606227	TotalAssetsEOY
Total Liabilities BOY	57193600	TotalLiabilitiesBOY
Total Liabilities EOY	56147370	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	72435208	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	70458857	NetAssetsOrFundBalancesEOY
Mission Description	TO MAKE QUALITY HEALTH CARE AVAILABLE ON A REGIONAL LEVEL TO THOSE IN NEED OF OUR SERVICE THROUGH DEDICATION, PROFESSIONALISM AND CHARITABLE ENDEAVORS WHILE MAINTAINING FINANCIAL STABILITY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	10102427	Expense
Description	INPATIENT ROUTINE CARE SERVICES TO INCLUDE NURSING, MEALS, HOUSEKEEPING, ETC. FOR 27,988 ROUTINE INPATIENT DAYS.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	5714353	Expense
Description	CUMBERLAND MEDICAL CENTER PERFORMED 10,311 SURGICAL PROCEDURES	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	6008329	Expense
Description	CUMBERLAND MEDICAL CENTER DISPENSED 1,069,233 PHARMACY DOSES.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	69808985	Expense
Description	ALL OTHER ROUTINE AND NECESSARY EXPENSES TO PROVIDE HEALTHCARE SERVICES IN A 182 BED ACUTE CARE HOSPITAL FACILITY PLUS A 20 BED SKILLED NURSING UNIT	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	69808985	TotalOfOtherProgramServiceExp
Total Program Service Expense	91634094	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Balance Sheet Amounts Reported	true	BalanceSheetAmountsReported
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	false	ScheduleORequired
Number Forms Transmitted With1096	80	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1278	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	TN	StatesWhereCopyOfReturnIsFiled
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	LARRY MOORE CFO	NamePerson
Telephone Number	9314849511	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	421 S MAIN ST	AddressLine1
City	CROSSVILLE	City
State	TN	State
ZIP Code	38555	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
EDWIN S ANDERSON
PRES/CEO	40.00	X	X	250461	0	4237
REYNALDO OLAECHEA MD
DIRECTOR	40.00	X		178067	0	29952
BETH PETTY MD
DIRECTOR		X		0	0	0
COSBY A STONE
DIRECTOR		X		0	0	0
JW BROWN
CHAIRMAN		X	X	0	0	0
JAMES BARNAWELL MD
DIRECTOR		X		0	0	0
KENNETH BURNETT
DIRECTOR		X		0	0	0
LARRY REED MD
DIRECTOR		X		0	0	0
ROBERT COUCH
SECRETARY		X	X	0	0	0
ROBERT HARRISON
DIRECTOR		X		0	0	0
ROY HOWARD
DIRECTOR		X		0	0	0
BARRY S WAGNER MD
CHIEF MEDICA	40.00		X	275016	0	16232
KENNETH R STEPHENS
EXEC. VICE P	40.00		X	131863	0	35128
RONALD M CAIN
VP PROF SVCS	40.00		X	104122	0	18424
COLDON L WILSON
VP NURSING	40.00		X	101876	0	12171
JINGER K LOGGINS
VP QUALITY	40.00		X	91119	0	4651
GNANARA J JOSEPH
PHYSICIAN	40.00			376898	0	47110	X
MOHAMED HEIKAL MD
PHYSICIAN	40.00			294385	0	20084	X
OSCAR E MENDEZ MD
PHYSICIAN	40.00			291793	0	28663	X
SIVALINGAM KANAGASEGAR MD
PHYSICIAN	40.00			274850	0	37738	X
ERNEST MAK MD
PHYSICIAN	40.00			257791	0	28952	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2628241	TotalReportableCompFromOrg
Total Other Compensation	283342	TotalOtherCompensation
Number Individuals GT100 K	27	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation	Business Name Line2NameOfContractor/NameBusiness/BusinessNameLine2
MOBILE TECH SVC
201 NORTH WHITE	ATHENS	TN	37303	MOBILE PET/CT	527000
SHELBY L HILL MD
59 MAGNOLIA LANE	CROSSVILLE	TN	38555	PHYSICIAN	354620
DR LOU MACMANUS DO
49 CLEVELAND STREET SUITE 310	CROSSVILLE	TN	38555	PHYSICIAN	354367
JAMES BARNWELL MD
421 SOUTH MAIN STREET	CROSSVILLE	TN	38555	PATHOLOGY	277200
CAREFUSION SOLUTION LLC
1952 SOLUTIONS CENTER	CHICAGO	IL	60677	MEDICATION DISP	275908	PYXIS PRODUCTS

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	9	NumberOfContractorsGT100K
Government Grants	48923	GovernmentGrants
All Other Contributions	9310	AllOtherContributions
Total Contributions	58233	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET PATIENT SERVICE REVENUE	Description
Total Revenue Column	101663219	TotalRevenueColumn
Related Or Exempt Function Income	101663219	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	101663219	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	815466	TotalRevenueColumn
Exclusion	$815,466	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	14537	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	165000	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-150463	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-150463	TotalRevenueColumn
Related Or Exempt Function Income	-150463	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	OTHER OPERATING REVENUE	Description
Total Revenue Column	532739	TotalRevenueColumn
Related Or Exempt Function Income	532739	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	532739	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	102919194	TotalRevenueColumn
Related Or Exempt Function Income	102045495	RelatedOrExemptFunctionIncome
Exclusion	$815,466	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	927338	Total
Program Services	751144	ProgramServices
Management And General	176194	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	40276970	Total
Program Services	32624346	ProgramServices
Management And General	7652624	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	10586913	Total
Program Services	8575400	ProgramServices
Management And General	2011513	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2930263	Total
Program Services	2373513	ProgramServices
Management And General	556750	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	76792	Total
Program Services	62201	ProgramServices
Management And General	14591	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	42280	Total
Program Services	42280	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	6878988	Total
Program Services	6878988	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	509097	Total
Program Services	509097	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	216045	Total
Program Services	216045	ProgramServices

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	12646	Total
Program Services	12646	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3878152	Total
Program Services	3141303	ProgramServices
Management And General	736849	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	84294	Total
Program Services	68961	ProgramServices
Management And General	15333	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	2721917	Total
Program Services	2721917	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	5696321	Total
Program Services	5696321	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2812315	Total
Program Services	2812315	ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL AND PATIENT SUPPL	12204249	12204249
BAD DEBT EXPENSE	9124020	9124020
OTHER	2379224	1927171	452053
PROFES & MGMT FEES	980793	794442	186351
OTHER SUPPLIES	792616	642019	150597

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	562613	Total
Program Services	455716	ProgramServices
Management And General	106897	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	103693846	Total
Program Services	91634094	ProgramServices
Management And General	12059752	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	12844614	BOY
EOY	11678958	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	13819857	BOY
EOY	16486124	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	17367091	BOY
EOY	15343671	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	174983	BOY
EOY	116768	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1701646	BOY
EOY	1688983	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	797065	BOY
EOY	867056	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	136971420	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	59067920	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	80194421	BOY
EOY	77903500	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	512949	BOY
EOY	476105	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	2216182	BOY
EOY	2045062	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	129628808	BOY
EOY	126606227	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	7022822	BOY
EOY	6045335	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	47148465	BOY
EOY	45287631	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	3022313	BOY
EOY	4814404	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	57193600	BOY
EOY	56147370	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	72224779	BOY
EOY	70268152	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	210429	BOY
EOY	190705	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	72435208	BOY
EOY	70458857	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	129628808	BOY
EOY	126606227	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2677519	OtherCostOrOtherBasis
Book Value	2677519	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	83743879	OtherCostOrOtherBasis
Depreciation	22582171	Depreciation
Book Value	61161708	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	48306092	OtherCostOrOtherBasis
Depreciation	35649540	Depreciation
Book Value	12656552	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2243930	OtherCostOrOtherBasis
Depreciation	836209	Depreciation
Book Value	1407721	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	77903500	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescription	AmountAmount
SWAP AGREEMENT LIABILITY	$4,079,803
CMC CAPITAL LEASE LIABILITY	$686,889
CMC DUE TO PREMIER PURCHASING	$32,305
CMC MOB SECURITY DEPOSITS	$15,407
TN HOSPITAL EDUCATION GRANT

Field	Value	IRS element (for citing)
Total Of Amounts	4814404	TotalOfAmounts
Total Revenue	102919194	TotalRevenue
Total Expenses	103693846	TotalExpenses
Excess Or Deficit For Year	-774652	ExcessOrDeficitForYear
Net Unrealized GL On Investments	107802	NetUnrealizedGLOnInvestments
Other	-$1,289,777	OtherAmount
Total Adjustments	-1181975	TotalAdjustments
Excess Or Deficit Per FS	-1956627	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	103026996	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	107802	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	107802	RevenueNotRptdF990
Revenue Subtotal	102919194	RevenueSubtotal
Total Revenue Per Form990	102919194	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	104983623	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	1289777	OtherExpensesIncluded
Expenses Not Rptd F990	1289777	ExpensesNotRptdF990
Expenses Subtotal	103693846	ExpensesSubtotal
Total Expenses Per Form990	103693846	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
RECONCILIATION OF CHANGES - OTHER	SCHEDULE D, PAGE 4, PART XI, LINE 8	UNREALIZED LOSSES -1,289,777
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER	SCHEDULE D, PAGE 4, PART XIII, LINE 2D	UNREALIZED LOSSES 1,289,777

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent150	X	Pcent150
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	false	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	606105	TotalCommunityBenefitExpense
Net Community Benefit Expense	606105	NetCommunityBenefitExpense
Percent Of Total Expense	0.00580	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12981619	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8051741	DirectOffsettingRevenue
Net Community Benefit Expense	4929878	NetCommunityBenefitExpense
Percent Of Total Expense	0.04750	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	13587724	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8051741	DirectOffsettingRevenue
Net Community Benefit Expense	5535983	NetCommunityBenefitExpense
Percent Of Total Expense	0.05340	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	144598	TotalCommunityBenefitExpense
Net Community Benefit Expense	144598	NetCommunityBenefitExpense
Percent Of Total Expense	0.00140	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8553674	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5484866	DirectOffsettingRevenue
Net Community Benefit Expense	3068808	NetCommunityBenefitExpense
Percent Of Total Expense	0.02960	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	9570	TotalCommunityBenefitExpense
Net Community Benefit Expense	9570	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8707842	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5484866	DirectOffsettingRevenue
Net Community Benefit Expense	3222976	NetCommunityBenefitExpense
Percent Of Total Expense	0.03110	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	22295566	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13536607	DirectOffsettingRevenue
Net Community Benefit Expense	8758959	NetCommunityBenefitExpense
Percent Of Total Expense	0.08450	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$3,474,922	BadDebtExpenseAmount
Amount Attributable To	639385	AmountAttributableTo
Amount Reimbursed By Medicare	38930178	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	39028500	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-98322	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	CST COMM HLTH LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	HEALTHCARE SERVICES/CARDIAC CATH	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.50000	OrganizationProfitOrOwnership

Form990 Schedule H Part V Form990ScheduleHPartV (11 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Critical Access HospitalCriticalAccessHospital
CUMBERLAND MEDICAL CENTER INC
421 S MAIN ST	CROSSVILLE	TN	38555	X
CMC HOME CARE
79 S MAIN ST	CROSSVILLE	TN	38555
CMC SKILLED NURSING
421 S MAIN ST	CROSSVILLE	TN	38555
CUMBERLAND PHYSICIANS GROUP
133 HAYES ST	CROSSVILLE	TN	38555
MONTEREY CLINIC
305 SOUTH HOLLY STREET SUITE A	MONTEREY	TN	38574
CMC WELLNESS COMPLEX
130 WOODMERE MALL	CROSSVILLE	TN	38555
CUMBERLAND MEDICAL CENTER AT FFG
130 STONEHENGE DR	CROSSVILLE	TN	38558
CMC OUTPATIENT IMAGING CENTER
28 HAYES ST	CROSSVILLE	TN	38555
CMC MEDICAL EQUIPMENT SERVICES
591 S MAIN ST	CROSSVILLE	TN	38555
CMC CANCER CENTER
421 S MAIN ST	CROSSVILLE	TN	38555
CMC OCCUPATIONAL MEDICINE
44 HAYES ST STE 202	CROSSVILLE	TN	38555

Form990 Schedule H Part VI Form990ScheduleHPartVI

Field	Value	IRS element (for citing)
Bad Debt Footnote	THE MEDICAL CENTER MAINTAINS ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE INABILITY OF ITS PATIENTS TO MAKE PAYMENTS. MANAGEMENT CONSIDERS THE FOLLOWING FACTORS WHEN DETERMING THE COLLECTIBILITY OF PATIENT ACCOUNTS: PAYOR CREDIT-WORTHINESS, PAST TRANSACTION HISTORY WITH THE PAYOR, CURRENT ECONOMIC INDUSTRY TRENDS, AND CHANGES IN PAYOR PAYMENT TERMS. IF THE FINANCIAL CONDITION OF THE MEDICAL CENTER'S PAYORS OR PATIENTS WERE TO DETERIORATE, ADVERSELY AFFECTING THEIR ABILITY TO MAKE PAYMENTS, ADDITIONAL ALLOWANCES WOULD BE REQUIRED. BASED ON MANAGEMENT'S ASSESSMENT, THE MEDICAL CENTER PROVIDES FOR ESTIMATED UNCOLLECTABLE AMOUNTS THROUGH A CHARGE TO EARNINGS AND A CREDIT TO AN ALLOWANCE. BALANCES THAT REMAIN OUTSTANDING AFTER THE MEDICAL CENTER HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.	BadDebtFootnote
Shortfall As Community Benefit	CUMBERLAND MEDICAL CENTER IS AN ACUTE CARE MEDICAL/SURGICAL FACILITY WHICH SERVES A LARGE TENNCARE AND MEDICARE POPULATION. WITH THIS DEMOGRAPHIC COMES THE REALIZATION OF LOW REIMBURSEMENT, BAD DEBT, AND MEDICARE SHORTFALLS. IN OUR AREA OF THE COUNTRY AND ESPECIALLY OUR AREA OF THE STATE, IT IS PART OF PROVIDING HEALTHCARE TO OUR PATIENTS. WE CONSIDER A LARGE PART OF WHAT WE MUST "WRITE-OFF" EACH YEAR AND THE MONEY THAT WE WILL NEVER SEE AS INCOME TO OUR BOTTOM LINE AS A BENEFIT THAT WE GIVE BACK TO OUR COMMUNITY. IT IS A SERVICE THAT WE ARE PROVIDING TO THOSE WHO CANNOT PROVIDE FOR THEMSELVES. OUR MISSION STATES THAT WE WILL MAKE AVAILABLE QUALITY HEALTH CARE ON A REGIONAL LEVEL TO THOSE IN NEED OF ITS SERVICE THROUGH DEDICATION, PROFESSIONALISM, AND FINANCIAL STABILITY. WHILE IT IS OUR FIDUCIARY RESPONSIBILITY TO MANAGE OUR FACILITY, IT IS OUR FIRST CONCERN TO CARE FOR THE PATIENT'S HEALTH AND WELL BEING. THE DIFFERENCE BETWEEN THOSE IN A COMMUNITY LIKE OURS WHEN ABSORBED BY THE HOSPITAL IS MOST DEFINITELY BENEFITTING THE COMMUNITY.	ShortfallAsCommunityBenefit

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	true	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	true	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg
EDWIN S ANDERSON
242674	7787	4237	254698
REYNALDO OLAECHEA MD
162413	3154	17481	208019	12500	12471
BARRY S WAGNER MD
275016		16232	291248
KENNETH R STEPHENS
130707	1156	16577	166991		18551
GNANARA J JOSEPH
224243	311	14110	424008	152344	33000
MOHAMED HEIKAL MD
197104		20084	314469	97281
OSCAR E MENDEZ MD
114276	4310	16718	320456	173207	11945
SIVALINGAM KANAGASEGAR MD
197874	452	21238	312588	76524	16500
ERNEST MAK MD
249916	7875	18028	286743		10924

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION	SCHEDULE J, PAGE 1, PART I, LINE 5A	LISTED EMPLOYED PHYSICIANS RECEIVE AN INCENTIVE BONUS EQUAL TO A PERCENTAGE OF CASH COLLECTIONS FROM THEIR OWN PRACTICE GREATER THAN THE PHYSICIAN'S ANNUAL SALARY.
COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION	SCHEDULE J, PAGE 1, PART I, LINE 6A	THE PRESIDENT/CEO AND OTHER OFFICERS RECEIVE AN INCENTIVE BONUS BASED ON VARIOUS CRITERIA, INCLUDING A COMPARISON OF ACTUAL NET EARNINGS TO BUDGETED NET EARNINGS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Business Name Line2IssuerName/BusinessNameLine2	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer
HEALTH EDUCATIONAL & HOUSING FACIL
OF THE CITY OF CHATTANOOGA	521298872	162410CAO	2004-11-18	46000000	FUND CONSTRUCTION AN	false	false
HEALTH AND EDUCATIONAL FACILITIES
BOARD OF THE CITY OF CROSSVILLE	581799575		2008-11-01	4200000	EQUIPMENT, FURNISHIN	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
42260000	747331	250809	36276661	2006	false	false	true	true
3027631			4041205	2009	false	false	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
false	false	false	false	true	true
false	false	false	false	true	true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
REGIONS BANK
false	true	true	10.0	false	false	true
(no name)
false	false	false		false	false	true

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ALL OTHER ACHIEVEMENTS DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4D	ALL OTHER ROUTINE AND NECESSARY EXPENSES TO PROVIDE HEALTHCARE SERVICES IN A 182 BED ACUTE CARE HOSPITAL FACILITY PLUS A 20 BED SKILLED NURSING UNIT
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11	MANAGEMENT AND THE BOARD OF DIRECTORS WILL REVIEW THE 990 BEFORE IT IS FILED.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	CUMBERLAND MEDICAL CENTER'S CONFLICT OF INTEREST STATEMENT IS DISCUSSED AND REVIEWED WITH POTENTIAL APPLICANTS FOR EMPLOYMENT DURING THE INTERVIEW PROCESS, WITH NEW EMPLOYEES DURING A NEW EMPLOYEE ORIENTATION AS WELL AS DURING DEPARTMENTAL ORIENTATION AND ANNUALLY FOR ALL EMPLOYEES DURING EACH EMPLOYEE'S ANNUAL PERFORMANCE REVIEW. IF NO CONFLICT OF INTEREST IS IDENTIFIED, IT IS NOTED ON THE CONFLICT OF INTEREST STATEMENT, SIGNED BY THE EMPLOYEE, AND PLACED IN THE EMPLOYEE'S FILE. IF A CONFLICT OF INTEREST IS IDENTIFIED, AFTER DISCUSSION AND REVIEW BY A CORPORATE OFFICER AND/OR OTHER ADDITIONAL INPUT AS NECESSARY, APPROPRIATE ACTION IS TAKEN UP TO AND INCLUDING TERMINATION OF EMPLOYMENT WITH CUMBERLAND MEDICAL CENTER OR THE OTHER EMPLOYER THAT IS CAUSING THE CONFLICT OF INTEREST.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE CEO REVIEW COMMITTEE AND THE EXECUTIVE COMPENSATION COMMITTEE REVIEW THE PERFORMANCE AND SALARY OF THE CEO ANNUALLY. THE COMMITTEES ARE APPOINTED ANNUALLY BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. TENNESSEE HOSPITAL ASSOCIATION SALARY SURVEY INFORMATION IS PROVIDED FOR REVIEW. DUE TO BUDGET CONSTRAINTS, NO WAGE INCREASE WAS PROVIDED DURING THE YEAR.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	THE PRESIDENT/CEO REVIEWS THE PERFORMANCE AND SALARY OF THE OFFICERS. TENNESSEE HOSPITAL ASSOCIATION SALARY SURVEY INFORMATION IS PROVIDED FOR REVIEW. DUE TO BUDGET CONSTRAINTS, NO WAGE INCREASES FOR OFFICERS WERE PROVIDED DURING THE YEAR.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	NO DOCUMENTS AVAILABLE TO THE PUBLIC

Schedule R IRS990ScheduleR

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	CST COMMUNITY HEALTH LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	421 S MAIN ST	AddressLine1
City	CROSSVILLE	City
State	TN	State
ZIP Code	38555	ZIPCode

Field	Value	IRS element (for citing)
EIN	621730751	EIN
Primary Activity	HEALTHCARE	PrimaryActivity
Legal Domicile State	TN	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeType
Share Of Total Income	-24247	ShareOfTotalIncome
Share Of EOY Assets	213241	ShareOfEOYAssets
Disproportionate Allocations	false	DisproportionateAllocations
General Or Managing Partner	true	GeneralOrManagingPartner

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	CST COMMUNITY HEALTH LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	R	TransactionType
Amount Involved	30000	AmountInvolved