MIAMI COUNTY MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MIAMI COUNTY MEDICAL CENTER INC (EIN 48-1155548)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201133199349308323
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T14:58:15-05:00 | 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 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1 |
| City | Kansas City | City |
| State | MO | State |
| ZIP Code | 641062246 | 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 | 481155548 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIAMI COUNTY MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIAM | NameControl |
| Phone | 9137914461 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 BAPTISTE DRIVE | AddressLine1 |
| City | PAOLA | City |
| State | KS | State |
| ZIP Code | 66071 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIERNEY L GRASSER | Name |
| Title | SENIOR VP/FINANCE | Title |
| Date Signed | 2011-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael J Engle | Name |
| Phone | 8162216300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIERNEY L GRASSER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20333 W 151ST STREET | AddressLine1 |
| City | OLATHE | City |
| State | KS | State |
| ZIP Code | 66061 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26376904 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.OLATHEHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | TO IMPROVE THE HEALTH OF ALL INDIVIDUALS IN THE COMMUNITIES WE SERVE BY PROVIDING COMPASSIONATE, QUALITY HEALTHCARE IN AN ENVIRONMENT OF TRUST AND COLLABORATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 176 | TotalNbrEmployees |
| Total Nbr Volunteers | 44 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 5405 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1332 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24209514 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 22307375 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 264547 | InvestmentIncomePriorYear |
| Investment Income Current Year | 867610 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 99281 | OtherRevenuePriorYear |
| Other Revenue Current Year | 118059 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24578747 | TotalRevenuePriorYear |
| Total Revenue Current Year | 23294376 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 102659 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 87994 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9464815 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9461454 | 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 | 11918871 | OtherExpensePriorYear |
| Other Expenses Current Year | 10941209 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 21486345 | TotalExpensesPriorYear |
| Total Expenses Current Year | 20490657 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3092402 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2803719 | RevenuesLessExpensesCY |
| Total Assets BOY | 38400159 | TotalAssetsBOY |
| Total Assets EOY | 42910451 | TotalAssetsEOY |
| Total Liabilities BOY | 8516371 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8097661 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 29883788 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 34812790 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF MIAMI COUNTY MEDICAL CENTER, INC. IS TO IMPROVE THE HEALTH OF ALL INDIVIDUALS IN THE COMMUNITIES WE SERVE BY PROVIDING COMPASSIONATE, QUALITY HEALTHCARE IN AN ENVIRONMENT OF TRUST AND COLLABORATION. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 15319095 | Expense |
| Grants | 87994 | Grants |
| Revenue | 22307375 | Revenue |
| Description | See schedule O | Description |
| Total Program Service Expense | 15319095 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | 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 |
| Financial Stmt Attached | false | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | 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 | true | 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 |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 25 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 176 | 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 |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | 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 | KS | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TIERNEY L GRASSER | NamePerson |
| Telephone Number | 9137914461 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20333 W 151ST STREET | AddressLine1 |
| City | OLATHE | City |
| State | KS | State |
| ZIP Code | 66061 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (10 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 |
|---|---|---|---|---|---|---|---|
| JACK TINNEL | |||||||
| TRUSTEE/CHAIRPERSON | 2.0 | X | X | 0 | 0 | 0 | |
| THOMAS J DAVIES | |||||||
| TRUSTEE/SECRETARY/TREASURER | 1.0 | X | X | 0 | 0 | 0 | |
| CHIP WOOD | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| STEVE MILLER | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| FRANK H DEVOCELLE | |||||||
| PRESIDENT/CEO | 7.0 | X | 0 | 795378 | 449886 | ||
| RODNEY D CORN | |||||||
| SENIOR VP/OPERATIONS | 7.0 | X | 0 | 344571 | 92888 | ||
| TIERNEY L GRASSER | |||||||
| SENIOR VP/FINANCE | 9.0 | X | 0 | 427897 | 170498 | ||
| GERALD WIESNER | |||||||
| VICE PRESIDENT/OPERATIONS | 40.0 | X | 160982 | 0 | 27754 | ||
| PAUL W LUCE | |||||||
| PATIENT CARE DIRECTOR | 40.0 | 119369 | 0 | 24209 | X | ||
| STEVEN B MOON | |||||||
| PHARMACY DIRECTOR | 40.0 | 113556 | 0 | 16141 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 393907 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1567846 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 781376 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| EMERGENCY MEDICAL CARE PA | |
| EMERGENCY SERVICES | 1600000 |
| SHARED MEDICAL SYSTEMS INC | |
| MRI SERVICES | 288628 |
| P1 GROUP INC | |
| HVAC MAINTENANCE | 110945 |
| KRAMER FRANK | |
| COLLECTION SERVICES | 106337 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| All Other Contributions | 1332 | AllOtherContributions |
| Total Contributions | 1332 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Service Revenue | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 22307375 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22307375 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 22307375 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 846538 | TotalRevenueColumn |
| Exclusion | $846,538 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 119418 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 143069 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -23651 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -23651 | TotalRevenueColumn |
| Exclusion | -$23,651 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2960531 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2749758 | Securities |
| Other | 189701 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 210773 | Securities |
| Other | -189701 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21072 | TotalRevenueColumn |
| Exclusion | $21,072 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| PURCHASE DISCOUNTS | 900099 | 33860 | $33,860 |
| Cafeteria | 722210 | 34439 | $34,439 |
| All Other Misc Revenue | 900099 | 73411 | $73,411 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 73411 | TotalRevenueColumn |
| Exclusion | $73,411 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 141710 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23294376 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22307375 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $985,669 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77744 | Total |
| Program Services | 77744 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10250 | Total |
| Program Services | 10250 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 188736 | Total |
| Program Services | 146886 | ProgramServices |
| Management And General | 41850 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29607 | Total |
| Program Services | 29607 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7641128 | Total |
| Program Services | 5946810 | ProgramServices |
| Management And General | 1694318 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118021 | Total |
| Program Services | 91852 | ProgramServices |
| Management And General | 26169 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 958505 | Total |
| Program Services | 745971 | ProgramServices |
| Management And General | 212534 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 525457 | Total |
| Program Services | 408944 | ProgramServices |
| Management And General | 116513 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105148 | Total |
| Management And General | 105148 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29859 | Total |
| Management And General | 29859 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3840 | Total |
| Management And General | 3840 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10092 | Total |
| Management And General | 10092 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3090251 | Total |
| Program Services | 1085672 | ProgramServices |
| Management And General | 2004579 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96340 | Total |
| Management And General | 96340 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3170177 | Total |
| Program Services | 2739790 | ProgramServices |
| Management And General | 430387 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 378561 | Total |
| Program Services | 340927 | ProgramServices |
| Management And General | 37634 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15287 | Total |
| Management And General | 15287 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 237739 | Total |
| Program Services | 213184 | ProgramServices |
| Management And General | 24555 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1453795 | Total |
| Program Services | 1303638 | ProgramServices |
| Management And General | 150157 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 226288 | Total |
| Program Services | 202916 | ProgramServices |
| Management And General | 23372 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 1781486 | 1781486 | |
| Repairs & Maintenance | 193330 | 80627 | 112703 |
| Recruitment | 950 | 950 | |
| Medicaid Assessment | 83921 | 83921 | |
| Dues & Subscriptions | 45420 | 17608 | 27812 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18725 | Total |
| Program Services | 11262 | ProgramServices |
| Management And General | 7463 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20490657 | Total |
| Program Services | 15319095 | ProgramServices |
| Management And General | 5171562 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 434966 | BOY |
| EOY | 363253 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4846826 | BOY |
| EOY | 4247760 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 509362 | BOY |
| EOY | 801393 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 203553 | BOY |
| EOY | 168976 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21231455 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15214354 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6998156 | BOY |
| EOY | 6017101 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25212628 | BOY |
| EOY | 31122444 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 194668 | BOY |
| EOY | 189524 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38400159 | BOY |
| EOY | 42910451 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1905292 | BOY |
| EOY | 1834574 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5483004 | BOY |
| EOY | 5216150 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1128075 | BOY |
| EOY | 1046937 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8516371 | BOY |
| EOY | 8097661 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29858947 | BOY |
| EOY | 34785070 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24841 | BOY |
| EOY | 27720 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29883788 | BOY |
| EOY | 34812790 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38400159 | BOY |
| EOY | 42910451 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2803719 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2125283 | ReconcilationOtherChanges |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $3,840 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 3840 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 24241897 | BeginningOfYearBalance |
| Contributions | 2406369 | Contributions |
| Investment Earnings Or Losses | 3273465 | InvestmentEarningsOrLosses |
| Other Expenditures | 12548 | OtherExpenditures |
| End Of Year Balance | 29909183 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 15324746 | BeginningOfYearBalance |
| Contributions | 3571697 | Contributions |
| Investment Earnings Or Losses | 5368894 | InvestmentEarningsOrLosses |
| Other Expenditures | 23440 | OtherExpenditures |
| End Of Year Balance | 24241897 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 16823777 | BeginningOfYearBalance |
| Contributions | 1922937 | Contributions |
| Investment Earnings Or Losses | -3411104 | InvestmentEarningsOrLosses |
| Other Expenditures | 10864 | OtherExpenditures |
| End Of Year Balance | 15324746 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.99910 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00090 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1475439 | OtherCostOrOtherBasis |
| Book Value | 1475439 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10013031 | OtherCostOrOtherBasis |
| Depreciation | 7953018 | Depreciation |
| Book Value | 2060013 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9132371 | OtherCostOrOtherBasis |
| Depreciation | 6915085 | Depreciation |
| Book Value | 2217286 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 610614 | OtherCostOrOtherBasis |
| Depreciation | 346251 | Depreciation |
| Book Value | 264363 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6017101 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $433,762 |
| INTEREST RATE SWAP | $613,175 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1046937 | TotalOfAmounts |
| Total Revenue | 23294376 | TotalRevenue |
| Total Expenses | 20490657 | TotalExpenses |
| Excess Or Deficit For Year | 2803719 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2257312 | NetUnrealizedGLOnInvestments |
| Other | -$132,029 | OtherAmount |
| Total Adjustments | 2125283 | TotalAdjustments |
| Excess Or Deficit Per FS | 4929002 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 305419703 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2257312 | NetUnrealizedGainsInvestments |
| Other Revenues | 279878107 | OtherRevenues |
| Revenue Not Rptd F990 | 282135419 | RevenueNotRptdF990 |
| Revenue Subtotal | 23284284 | RevenueSubtotal |
| Investment Expenses Not Included | 10092 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 10092 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 23294376 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 264336960 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 243856395 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 243856395 | ExpensesNotRptdF990 |
| Expenses Subtotal | 20480565 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 10092 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 10092 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 20490657 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIBE THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS | SCHEDULE D, PART V, LINE 4 | THE ENDOWMENT FUNDS ARE HELD FOR FUTURE CAPITAL AND EXPANSION NEEDS. IN ADDITION, THE FUNDS ALSO REPRESENT RESERVES FOR OPERATING NEEDS TO REMAIN FINANCIALLY STABLE. |
| UNCERTAIN TAX POSITIONS DISCLOSURE | SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| OTHER - RECONCILIATION OF REVENUE PER AUDITED F/S AND TAX RETURN | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 17,108 NET ASSETS RELEASED - CAPITAL 7,128 UNREALIZED LOSS ON INTEREST RATE SWAP (159,144) CHANGE IN TEMPORARILY RESTRICTED NA 2,879 ---------- TOTAL $(132,029) | |
| OTHER - REVENUE INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 | SCHEDULE D, PART XII, LINE 2D | RELATED ORGANIZATIONS' REVENUE 279,894,182 UNREALIZED LOSS ON INTEREST RATE SWAP (159,144) RENTAL EXPENSES 143,069 ---------- TOTAL $279,878,107 |
| OTHER - EXPENSE INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 | SCHEDULE D, PART XIII, LINE 2D | RELATED ORGANIZATIONS' EXPENSES 243,713,326 RENTAL EXPENSES 143 069 ------------ TOTAL $243,856,395 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 250. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 0 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1206 | PersonsServed |
| Total Community Benefit Expense | 962317 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 962317 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04700 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1619 | PersonsServed |
| Total Community Benefit Expense | 1856529 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 760114 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1096415 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05350 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2825 | PersonsServed |
| Total Community Benefit Expense | 2818846 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 760114 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2058732 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10050 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 472 | PersonsServed |
| Total Community Benefit Expense | 3473 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 222 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3251 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18 | PersonsServed |
| Total Community Benefit Expense | 23457 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 23457 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 187 | PersonsServed |
| Total Community Benefit Expense | 49678 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 49678 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 677 | PersonsServed |
| Total Community Benefit Expense | 76608 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 222 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 76386 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3502 | PersonsServed |
| Total Community Benefit Expense | 2895454 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 760336 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2135118 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10420 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $517,509 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5404026 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6502012 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1097986 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | 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 | MIAMI COUNTY MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 BAPTISTE DRIVE | AddressLine1 |
| City | PAOLA | City |
| State | KS | State |
| ZIP Code | 66071 | 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 | MIAMI COUNTY MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| LOUISBURG REHAB OF MIAMI CTY MEDICAL CTR | ||||
| 102 W CRESTVIEW CIRCLE | LOUISBURG | KS | 66053 | OUTPATIENT REHABILITATION CLINIC |
| OSAWATOMIE REHAB OF MIAMI CTY MED CENTER | ||||
| 539 MAIN STREET | OSAWATOMIE | KS | 66064 | OUTPATIENT REHABILITATION CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FAMILY INCOME LIMIT FOR ELIGIBILITY FOR DISCOUNTED CARE | SCHEDULE H, PART I, LINE 3B | MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) OFFERS DISCOUNTED CARE TO ALL INDIVIDUALS WITHOUT INSURANCE, SIMILAR TO MANAGED CARE DISCOUNTS. MCMCI'S UNINSURED DISCOUNT APPLIES TO ALL PATIENTS WITHOUT INSURANCE, INLUDING ALL LOW INCOME INDIVIDUALS. |
| SCHEDULE H, PART I, LINE 7, COLUMN F | THE BAD DEBT EXPENSE IS NOT CONSIDERED A COMMUNITY BENEFIT EXPENSE AND IS NOT INCLUDED IN SCHEDULE H, PART I, LINE 7. | |
| SCHEDULE H, PART I, LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST ACCOUNTING SYSTEM. | |
| BAD DEBT EXPENSE | SCHEDULE H, PART III, LINE 4 | THE SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. THE SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON A BILLING CYCLE THAT REPEATEDLY ADVISES RECIPIENTS THEY MAY APPLY FOR FINANCIAL ASSISTANCE AND PROVIDES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE, IN ADDITION TO UTILIZING PROPENSITY TO PAY SOFTWARE TO HELP IDENTIFY PATIENTS THAT MAY BE IN NEED OF ASSISTANCE, BUT HAVE NOT COMPLETED AND PROVIDED AN APPLICATION.ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON A BILLING CYCLE THT REPEATEDLY ADVISES RECIPIENTS THEY MAY APPLY FOR FINANCIAL ASSISTANCE AND PROVIDES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE. IN ADDITION, MCMCI UTILIZES PROPENSITY TO PAY SOFTWARE TO HELP IDENTIFY PATIENTS THAT MAY BE IN NEED OF ASSISTANCE, BUT HAVE NOT COMPLETED OR PROVIDED A CHARITY CARE APPLICATION. BASED UPON THE SOFTWARE'S CRITERIA, INDIVIDUALS MAY QUALIFY FOR FINANCIAL ASSISTANCE WITHOUT COMPLETION OF THE ACTUAL APPLICATION. INDIVIDUAL PATIENT BALANCES WHO DO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT CONSIDERED BAD DEBT EXPENSE SUBJECT TO COLLECTIONS, BUT ARE CONSIDERED CHARITY CARE EXPENSE. AN OVERALL COST TO CHARGE RATIO IS USED TO CALCULATE THE BAD DEBT EXPENSE AT COST. |
| COLLECTION PRACTICES | SCHEDULE H, PART III, LINE 9B | BEFORE PLACEMENT WITH COLLECTION AGENCIES, MCMCI PATIENT FINANCIAL SERVICES OFFERS VARIOUS OPTIONS FOR PATIENTS WITH FINANCIAL DIFFICULTIES. IN ADDITION TO OFFERING OUR OWN FINANCIAL ASSISTANCE TO QUALIFYING INDIVIDUALS, MCMCI CONTRACTS WITH AN AGENCY THAT SCREENS INDIVIDUALS FOR ELIGIBILITY FOR PROGRAMS LIKE MEDICAID, DISABILITY, AND CRIME VICTIMS' COMPENSATION AND THEN HELPS THEM THROUGH THE APPLICATION PROCESS. THE USE OF PROPENSITY TO PAY SOFTWARE ALSO HELPS MCMCI IDENTIFY INDIVIDUALS THAT MAY NEED ASSISTANCE THAT HAVE NOT COMPLETED AN APPLICATION. MCMCI HAS LANGUAGE WRITTEN IN THEIR COLLECTION AGENCY CONTRACT THAT STATES, "IF THE COLLECTION AGENCY LEARNS A PATIENT/DEBTOR HAS NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET HIS FINANCIAL OBLIGATION, THE AGENCY WILL NOT PURSUE COLLECTION ACTIVITIES AGAINST THE PATIENT/DEBTOR, UNLESS OR UNTIL THE AGENCY LEARNS THAT THE PATIENT/DEBTOR HAS INCOME OR ASSETS TO MEET THE OBLIGATION." IF THE COLLECTION AGENCY IS NOTIFIED BY THE PATIENT/DEBTOR THAT THIS CREATES AN UNDUE FINANCIAL HARDSHIP OR BURDEN DUE TO A CHANGE IN THEIR INCOME OR ASSETS, THE AGENCY WILL NOTIFY MCMCI AND AWAIT FURTHER DIRECTION FROM THE HOSPITAL. |
| NEEDS ASSESMENT | SCHEDULE H, PART VI, LINE 2 | MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) WORKS VERY CLOSELY WITH THE MIAMI COUNTY HEALTH DEPARTMENT IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITY. IN A MORE GRASSROOTS EFFORT, MCMCI ALSO USES QUESTIONNAIRES AT VARIOUS COMMUNITY-BASED HEALTH FAIRS AND PUBLIC EVENTS TO BETTER UNDERSTAND THE HEALTHCARE NEEDS. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | PATIENTS OF MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) ARE MADE AWARE OF ALL OPPORTUNITIES AVAILABLE FOR FINANCIAL ASSISTANCE IN A VARIETY OF WAYS. THERE ARE SIGNS IN THE REGISTRATION AREAS TO NOTIFY PATIENTS AND VISITORS OF THE AVAILABILITY OF ASSISTANCE PROGRAMS. EVERY BILLING STATEMENT CONTAINS A NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN ADDITIONAL INFORMATION OR APPLY. APPLICATIONS AND INSTRUCTIONS ARE AVAILABLE ON THE MEDICAL CENTER'S WEBSITE, IN BOTH ENGLISH AND SPANISH. PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND SOCIAL WORKERS ARE TRAINED TO PROVIDE APPLICATIONS TO PATIENTS IF THEY EXPRESS ANY CONCERN REGARDING ABILITY TO PAY FOR SERVICES, OR MAY BE REFERRED TO AN AGENCY THE MEDICAL CENTER CONTRACTS WITH TO HELP INDIVIDUALS THROUGH THE APPLICATION PROCESS FOR PROGRAMS LIKE MEDICAID AND DISABILITY. PATIENTS THAT CALL OUR PATIENT FINANCIAL SERVICES DEPARTMENT EXPRESSING CONCERNS ABOUT BEING ABLE TO PAY FOR THEIR SERVICE OR EXPRESS THEY ARE EXPERIENCING A FINANCIAL HARDSHIP ARE ADVISED OF OUR ASSISTANCE POLICY AND ENCOURAGED TO APPLY. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 3 | MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) SERVES THE PEOPLE OF MIAMI AND LINN COUNTIES IN KANSAS. MIAMI AND LINN COUNTIES ARE BOTH LOCATED IN RURAL AREAS OF THE STATE OF KANSAS AND ARE BOTH FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS IN KANSAS. THERE ARE NO OTHER HOSPITALS LOCATED IN THESE TWO COUNTIES, HOWEVER THERE ARE SEVERAL OTHER HOSPITALS LOCATED IN NEARBY METROPOLITAN AREAS INCLUDING OLATHE, KANSAS AND KANSAS CITY, MISSOURI. BELOW IS A TABLE DEMONSTRATING THE DEMOGRAPHICS OF BOTH MIAMI AND LINN COUNTIES AS OUTLINED BY THE U.S. CENSUS BUREAU: MIAMI COUNTY (APPROXIMATIONS) Total Population 32,787 Median Household Income $57,705 Median Household Income as a percentage of National Median Household Income 105% Percent of People below the Poverty Level 9.1% Percent of People 65+ 13.1% Estimated Miami County Population oN Medicare (based on age 65+) 4,295 Estimated Miami County Population on Medicaid (based on Poverty Level) 2,984 LINN COUNTY (APPROXIMATIONS) Total Population 9,656 Median Household Income $41,597 Median Household Income as a percentage of National Median Household Income 76% Percent of People below the Poverty Level 12.8% Percent of People 65+ 19.3% Estimated Linn County Population on Medicare (based on age 65+) 1,864 Estimated Linn County Population on Medicaid (based on Poverty Level) 1,224 IN ADDITION TO THE GENERAL HEALTH CARE SERVICES PROVIDED BY THE HOSPITAL AND ITS ASSOCIATED PHYSICIANS, MCMCI SERVES A DIVERSE POPULATION OF MENTALLY DISABLED PATIENTS. THE OSAWATOMIE STATE HOSPITAL, LAKE MARY CENTER, MEDICALODGE OF PAOLA AND TRI-KO ARE ALL ORGANIZATIONS LOCATED IN THE MCMCI SERVICE AREA TO PROVIDE ASSISTANCE TO PERSONS WITH DEVELOPMENTAL DISABILITIES. MCMCI SUPPORTS EACH OF THESE ORGANIZATIONS BY PROVIDING MEDICAL CARE TO THEIR RESIDENTS. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5 | IN ADDITION TO THE ACTIVITIES LISTED ABOVE, MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) IS A SIGNIFICANT SUPPORTER OF LOCAL, REGIONAL AND NATIONAL ORGANIZATIONS FOR HEART DISEASE, DIABETES, ARTHRITIS, CANCER, AND VARIOUS OTHER DISEASES. MCMCI ALSO PROVIDES ATHLETIC TRAINING SERVICES VALUED AT $46,296 FOR AREA HIGH SCHOOL ATHLETICS. |
| AFFILIATED HEALTH CARE SYSTEM | SCHEDULE H, PART VI, LINE 6 | MIAMI COUNTY MEDICAL CENTER IS A PART OF OLATHE HEALTH SYSTEM, INC. (OHSI) WHICH CONSISTS OF TWO HOSPITALS AND A NETWORK OF 34 CLINICS. OHSI AND ITS AFFILIATES, INCLUDING MIAMI COUNTY MEDICAL CENTER, TAKE A LEADERSHIP ROLE IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. OHSI HOSPITALS AND CLINICS ARE VERY INVOLVED WITH COMMUNITY OUTREACH EDUCATION AND SCREENING PROGRAMS ACROSS THE ENTIRE SERVICE AREA. WE COLLABORATE WITH AREA COMPANIES AND OTHER HEALTH-RELATED SERVICE PROVIDERS TO PROVIDE EDUCATION AND SCREENINGS TO THE PUBLIC. OHSI POSITIONS ITSELF AS NOT ONLY A PROVIDER OF CARE, BUT A RESOURCE FOR EDUCATION AND PREVENTION. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | SCHEDULE H, PART VI, LINE 7 | ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: MCMCI IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE, BUT WE MAKE OUR REPORT AVAILABLE TO ANYONE INTERESTED AT WWW.OLATHEHEALTH.ORG. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| LAKEMARY ENDOWMENT | ||||||||||
| 100 LAKEMARY DRIVE | PAOLA | KS | 66071 | 237423516 | 501(C)(3) | 7500 | CMTY WELLNESS | |||
| SCHOOL DISTRICT #368 | ||||||||||
| PO BOX 268 | PAOLA | KS | 66071 | 480720746 | GOVERNMENT | CMTY WELLNESS | 15432 | BOOK | SPORTS MEDICINE | |
| SPRING HILL SCHOOLS | ||||||||||
| 101 E SOUTH ST | SPRING HILL | KS | 66083 | 480725304 | GOVERNMENT | CMTY WELLNESS | 15432 | BOOK | SPORTS MEDICINE | |
| OSAWATOMIE SCHOOL DISTRICT | ||||||||||
| 1200 TROJAN DRIVE | OSAWATOMIE | KS | 66064 | GOVERNMENT | CMTY WELLNESS | 15432 | BOOK | SPORTS MEDICINE | ||
| YMCA | ||||||||||
| 300 11th st | Osawatomie | KS | 66064 | 310537179 | 501(C)(3) | 6000 | CMTY WELLNESS | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 12 | NumberOfRecipients |
| Amount Of Cash Grant | 10250 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCESS FOR MONITORING THE USE OF GRANTS IN THE U.S. | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | MIAMI COUNTY MEDICAL CENTER, INC. PROVIDED SPORTS TRAINERS TO LOCAL HIGH SCHOOLS. FOR ALL SCHOLARSHIPS, THE ORGANIZATION CAREFULLY SELECTS THE RECIPIENTS OF THE FUNDS AND A CHECK IS WRITTEN DIRECTLY TO THE ORGANIZATION OR INDIVIDUAL. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FRANK H DEVOCELLE | |||||||||||||
| 0 | 561099 | 0 | 185698 | 0 | 48581 | 0 | 415497 | 0 | 34389 | 0 | 1245264 | 0 | 185698 |
| RODNEY D CORN | |||||||||||||
| 0 | 247881 | 0 | 55392 | 0 | 41298 | 0 | 72995 | 0 | 19893 | 0 | 437459 | 0 | 74088 |
| TIERNEY L GRASSER | |||||||||||||
| 0 | 322307 | 0 | 67168 | 0 | 38422 | 0 | 142616 | 0 | 27882 | 0 | 598395 | 0 | 79848 |
| GERALD WIESNER | |||||||||||||
| 151905 | 0 | 0 | 0 | 9077 | 0 | 11302 | 0 | 16452 | 0 | 188736 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SOCIAL CLUB DUES OR INITIATION FEES | SCHEDULE J, PART I, LINE 1A | SOCIAL CLUB DUES WERE PAID BY THE HOSPITAL FOR GERALD WIESNER AND WERE NOT INCLUDED IN HIS W-2 AS TAXABLE COMPENSATION BECAUSE IT WAS 100% BUSINESS USE. |
| ESTABLISHMENT OF OFFICER COMPENSATION | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 AND PART II | THE COMPENSATION BEING REPORTED FOR GERALD WIESNER WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF OLATHE MEDICAL CENTER, INC. THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER INC. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS, WHICH INCLUDES A BOARD MEMBER FROM MIAMI COUNTY MEDICAL CENTER, INC. THE COMMITTEE UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT AND THIRD PARTY SALARY SURVEYS IN THE ESTABLISHMENT OF MR. WIESNER'S COMPENSATION. |
| COMPENSATION FROM A RELATED ORGANIZATION | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 AND PART II | THE COMPENSATION BEING REPORTED FOR FRANK H DEVOCELLE, RODNEY D CORN AND TIERNEY L GRASSER BY A RELATED ORGANIZATION IS FROM OLATHE MEDICAL CENTER, INC. THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. OLATHE MEDICAL CENTER, INC. USES A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT BOARD MEMBERS TO ESTABLISH COMPENSATION AND BENEFITS FOR ALL OFFICERS OF OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED CORPORATIONS. THE COMPENSATION COMMITTEE APPROVES AND ESTABLISHES ALL COMPENSATION AND BENEFITS FOR OFFICERS OF OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED COMPANIES. THEY UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN CONTRACT FOR THE CEO AND COMPENSATION SURVEYS TO ESTABLISH FAIR MARKET VALUE SALARIES AND BENEFITS FOR OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATES' OFFICERS. |
| SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | SCHEDULE J, PART I, LINE 4B & PART II | A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IS PROVIDED TO FRANK H DEVOCELLE WHICH IS FUNDED OVER A SHORT TIME PERIOD BASED UPON THE IMPLEMENTATION DATE OF THE SERP IN 2005. MR. DEVOCELLE'S CAREER SERVICE AT OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES IS CURRENTLY AT 39 YEARS, MOST OF WHICH DID NOT INCLUDE FUNDING FOR THE SERP BENEFIT. A MAJORITY OF THE DEFERRED COMPENSATION IS DUE TO FUNDING OF THE SERP BENEFIT FOR PRIOR YEARS OF SERVICE. A SERP is also provided to Tierney L Grasser which is funded over a short time period based upon the implementation date of the SERP in 2005. Ms. Grasser's career service at Olathe Medical Center, Inc. and its affiliated entities is currently at 22 years, most of which did not include funding for the SERP benefit. A majority of the deferred compensation is due to funding of the SERP benefit for prior years of service. Certain physicians participate in a deferred compensation benefit plan. OFFICER SERP FRANK H DEVOCELLE $267,908 (AT LEAST 90% ATTRIBUTABLE TO UNDER FUNDING IN PRIOR YEARS) TIERNEY L GRASSER $ 68,226 (AT LEAST 85% ATTRIBUTABLE TO UNDER FUNDING IN PRIOR YEARS) RODNEY D CORN $ 24,803 |
| COMPENSATION REPORTED IN PRIOR YEAR FORM 990 | SCHEDULE J, PART II, COLUMN F | COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS GENERALLY REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS PAID TO THE INDIVIDUAL. AS A RESULT OF THE REPORTING REQUIREMENT, AN ORGANIZATION COULD BE REQUIRED TO REPORT THE SAME COMPENSATION AMOUNTS ON THE FORM 990 FOR TWO CONSECUTIVE YEARS. The amounts reported in column F: include incentive amounts and capital accumulation amounts which were reported in previous 990s as deferred compensation. |
| RETIREMENT AND OTHER DEFERRED COMPENSATION | SCHEDULE J, PART II, COLUMN C | IN 2010, THE BONUS AND INCENTIVE COMPENSATION WAS ACCRUED, BUT NOT PAID UNTIL 2011. THEREFORE, COLUMN (C) REFLECTS, THE ACCRUED INCENTIVE AMOUNTS FOR 2010, SERP PAYMENTS (SEE ABOVE FOR FURTHER EXPLANATION) AND OTHER DEFERRED COMPENSATION. ACCRUED TOTAL INCENTIVE SERP OTHER COLUMN C FRANK H DEVOCELLE $135,830 $267,908 $11,759 $415,497 RODNEY D CORN 35,864 24,803 12,328 72,995 TIERNEY L GRASSER 57,728 68,226 16,662 142,616 GERALD WIESNER 9,702 -0- 1,600 11,302 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF OLATHE KANSAS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 486034756 | IssuerEIN |
| CUSIP Number | 679390GX6 | CUSIPNumber |
| Date Issued | 2008-02-27 | DateIssued |
| Issue Price | 5311403 | IssuePrice |
| Description Of Purpose | SEE SCHEDULE K, PART V | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 75000 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 5311403 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 22312 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 0 | CapitalExpenditures |
| Other Spent Proceeds | 5289091 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | false | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Superintegrated Hedge | false | SuperintegratedHedge |
| Hedge Terminated | false | HedgeTerminated |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| BOND ISSUES | SCH K, PART I, LINE A | A-(e)- THE ISSUE PRICE OF THE ENTIRE ISSUE IS $29,451,544. A PORTION OF THE ISSUE PRICE, EQUAL TO $24,140,141 IS ALLOCABLE TO OLATHE MEDICAL CENTER, INC. THE REMAINDER OF THE ISSUE PRICE, EQUAL TO $5,311,403, IS ALLOCABLE TO MIAMI COUNTY MEDICAL CENTER, INC., WHICH IS CONTROLLED BY OLATHE MEDICAL CENTER, INC., ITS SOLE MEMBER. A-(f)- REFUND SERIES 2004A BONDS ISSUED 7/29/2004 AND REFUND SERIES 2004B BONDS ISSUED 7/29/2004. |
| PROCEEDS | SCH K, PART II, COLUMN A | LINES 11 & 14- OTHER THAN ISSUANCE COSTS, THE ENTIRE PROCEEDS WERE USED TO CURRENTLY REFUND SERIES 2004A BONDS ISSUED 7/29/2004 AND REFUND SERIES 2004B BONDS ISSUED 7/29/2004 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SEE SCHEDULE L PART V | NamePerson |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS WITH INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV | ReturnReference |
| Explanation | TRANSACTION 5 (A) HEIDI HANSON (B) HEIDI HANSON IS THE DAUGHTER OF FRANK H DEVOCELLE, AN OFFICER OF MCMCI (C) $29,607 (D) HEIDI HANSON IS AN EMPLOYEE OF MCMCI (E) NO | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (17 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4A | Miami County Medical Center, Inc. operates an acute care hospital in Paola, Kansas. Miami County Medical Center, Inc. carries out its mission by providing quality and compassionate inpatient, outpatient, and emergency care services to residents in Miami County, Kansas and surrounding area. Miami County Medical Center, Inc. is a Joint Commission accredited hospital and is licensed for 39 beds and currently staffs 18 inpatient beds. Program services expenses are all related to the provision of healthcare services. In 2010, Miami County Medical Center, Inc. provided 1,572 days of inpatient care, provided 59,464 outpatient procedures, and 9,786 emergency visits to the community. Educational Support In addition to providing uncompensated care for patients in need, the Medical Center provides other health care related benefits to the communities it serves by providing 24-hour emergency rooms open every day to the public regardless of ability to pay. The Medical Center also provides education for a variety of medical professionals, health care screenings and education programs for the general public and support group sponsorships. Sports Net Miami County Medical Center provides Athletic Training staff for area high schools and junior high schools during the school year through its Sports Net program. In 2010, $42,296 of Athletic Trainer services was provided to the schools in the Medical Center's service area. Contributions Miami County Medical Center supports a variety of social, education, and civic healthcare related organizations within its service area. In 2010, $33,172 was contributed to various agencies and charitable organizations and $10,250 in scholarships. |
| ATTACHMENT OF AUDITED FINANCIAL STATEMENTS | FORM 990, PART IV, LINE 20B | PER THE IRS' FORM 990 INSTRUCTIONS, AN ORGANIZATION OPERATING ONE OR MORE HOSPITALS AT ANY TIME DURING THE YEAR MUST ATTACH A COPY OF ITS AUDITED FINANCIAL STATEMENTS TO THE TAX RETURN IF ITS TAX YEAR BEGAN AFTER MARCH 23, 2010. MIAMI COUNTY MEDICAL CENTER'S AUDITED FINANCIAL STATEMENTS ARE NOT ATTACHED BECAUSE ITS TAX YEAR BEGAN ON JANUARY 1, 2010. |
| BUSINESS RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | FRANK H DEVOCELLE, RODNEY D CORN AND TIERNEY L GRASSER HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. THEY SERVE AS AN OFFICER OR DIRECTOR FOR OLATHE HEALTH DEVELOPMENT CORPORATION, HEALTH ACCESS, INC. OR OLATHE MEDICAL CENTER DOCTOR'S BUILDING CONDOMINIUM OWNERS ASSOCIATION, WHICH ARE RELATED FOR PROFIT COMPANIES. |
| MEMBER | FORM 990, PART VI, SECTION A, LINE 6 | OLATHE MEDICAL CENTER, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. |
| MEMBER MAY ELECT GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7A | OLATHE MEDICAL CENTER, INC. BEING THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES. |
| GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBER | FORM 990, PART VI, SECTION A, LINE 7B | OLATHE MEDICAL CENTER, INC. IS THE SOLE MEMBER, AND HAS THE RIGHTS TO APPROVE MIAMI COUNTY MEDICAL CENTER, INC.'S BYLAWS AND ARTICLES OF INCORPORATION AND ALSO APPROVE MIAMI COUNTY MEDICAL CENTER'S BOARD MEMBERS AND CERTAIN CAPITAL EXPENDITURES. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | The tax return form 990 is reviewed by the Audit and compliance Committee of the Olathe Medical Center, Inc. (Miami County Medical Center's sole member) board on behalf of all of its affiliates prior to filing the return with the Internal Revenue Service. The Audit & Compliance Committee is comprised of independent Board members of Olathe Medical Center, Inc. The final form 990 with all required schedules is then provided to all board members for review prior to filing the form 990. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | The purpose of the Organization's Conflict of Interest Policy is to protect the organization's interest when it is contemplating a decision or entering into a transaction or arrangement that might benefit the private interest of any person in a position of authority over the organization, or might result in a possible excess benefit transaction. Corporate officers and members of the Board of Trustees review the Conflict of Interest Policy and complete a Disclosure of Information Form annually. A summary of the annual disclosures of information is provided to the full Board for review at least one time per year. The conflict of interest policy calls for any interested person to disclose the existence of a financial relationship or competitive interest in connection with any pending transaction or arrangement. The individual is given the opportunity to disclose all material facts to the Trustees considering the proposed transaction or arrangement that gave rise to the disclosure. When a transaction involves an interested party, the follow procedures are followed: 1. The interested party leaves the meeting after providing any material facts or discussion regarding the matter that gives rise to the interest unless requested to stay by the remaining board or committee members. 2. If appropriate, the Board may appoint a non-interested person or committee to investigate alternatives to the proposed transaction; 3. The interested trustee may not vote in the matter that gives rise to the interest. 4. In order to approve the transaction, the Board must first find, by a majority vote of the trustees then in office, without counting the vote of the interested trustee, a. That the proposed transaction is in the Organization's best interests and for its own benefit, and b. That, after reasonable investigation, the board has determined that the organization cannot obtain a more advantageous transaction with reasonable efforts under the circumstances. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & B | The compensation committee of the Olathe Medical Center, Inc. board, which is comprised of independent members of the board of Olathe Medical Center, Inc. and its affiliates, including a Miami County Medical Center, Inc. board member, reviews and approves the CEO and other officers and key employees of the corporation's compensation in accordance with their compensation policy. The compensation committee reviews third party salary surveys and also utilizes written contracts for the ceo to determine the fair market value of the current compensation, salary ranges and benefits. Compensation for such officers is approved by the committee and information of their findings is available to all board members at their request. |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | UNREALIZED GAIN ON INVESTMENTS 2,257,312 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 17,108 NET ASSETS RELEASED- CAPITAL 7,128 UNREALIZED LOSS ON INTEREST RATE SWAP (159,144) CHANGE IN TEMPORARILY RESTRICTED NA 2,879 ----------- TOTAL $2,125,283 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JACK TINNEL TITLE:TRUSTEE/CHAIRPERSON HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS J DAVIES TITLE:TRUSTEE/SECRETARY/TREASURER HOURS:4 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CHIP WOOD TITLE:TRUSTEE HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FRANK H DEVOCELLE TITLE:PRESIDENT/CEO HOURS:43 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RODNEY D CORN TITLE:SENIOR VP/OPERATIONS HOURS:43 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:TIERNEY L GRASSER TITLE:SENIOR VP/FINANCE HOURS:41 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| OLATHE MEDICAL CENTER INC | |||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 480577664 | HOSPITAL | KS | 501(C)(3) | 3 | OHSI |
| OLATHE HEALTH SYSTEM INC | |||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 480979845 | SUPPORT ORG | KS | 501(C)(3) | 11B | NA |
| OLATHE MEDICAL SERVICES INC | |||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 481088982 | CLINICS | KS | 501(C)(3) | 9 | OMCI |
| OLATHE MEDICAL CENTER CHARITABLE FDN | |||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 481136010 | SUPPORT OMCI | KS | 501(C)(3) | 7 | OMCI |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTH ACCESS INC | |||||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 742855334 | HEALTH INSURANCE | KS | NA | C CORPORATION | 0 | 0 | 0.00000 |
| OMC DOCTOR'S BLDG CONDO OWNERS ASSOC INC | |||||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 481244766 | REAL ESTATE | KS | NA | C CORPORATION | 0 | 0 | 0.00000 |
| OLATHE HEALTH DEVELOPMENT CORPORATION | |||||||||||
| 20333 W 151ST ST | OLATHE | KS | 66061 | 363445097 | MEDICAL SERVICES | KS | NA | C CORPORATION | 0 | 0 | 0.00000 |
| 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 | true | 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 | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |