BOLIVAR MEDICAL CENTER FOUNDATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BOLIVAR MEDICAL CENTER FOUNDATION (EIN 64-0923090)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-05-12
IRS object ID
201141329349303179
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-12T15:28:10-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JACKSON & BRASWELL PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 298AddressLine1
CityCLEVELANDCity
StateMSState
ZIP Code38732ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN640923090EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BOLIVAR MEDICAL CENTER FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBOLINameControl
Phone6628431555Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 298AddressLine1
CityCLEVELANDCity
StateMSState
ZIP Code38732ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK HARGETTName
TitleCHAIRMANTitle
Phone6628431555Phone
Date Signed2011-05-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKENNETH E MULLINSName
Phone6628431555Phone
Date Prepared2011-05-11DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts11188986GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileMSStateLegalDomicile
Activity Or Mission DescriptionTHE PURPOSE OF THE FOUNDATION IS TO PROMOTE THE HEALTH OF THE CITIZENS OF BOLIVAR COUNTY, MISSISSIPPI.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year5212386InvestmentIncomePriorYear
Investment Income Current Year3326096InvestmentIncomeCurrentYear
Other Revenue Prior Year7390OtherRevenuePriorYear
Other Revenue Current Year782OtherRevenueCurrentYear
Total Revenue Prior Year5219776TotalRevenuePriorYear
Total Revenue Current Year3326878TotalRevenueCurrentYear
Grants And Similar Amnts CY480714GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year522556OtherExpensePriorYear
Other Expenses Current Year184081OtherExpensesCurrentYear
Total Expenses Prior Year522556TotalExpensesPriorYear
Total Expenses Current Year664795TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4697220RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2662083RevenuesLessExpensesCY
Total Assets BOY32559156TotalAssetsBOY
Total Assets EOY35221239TotalAssetsEOY
Total Liabilities BOY335477TotalLiabilitiesBOY
Total Liabilities EOY335477TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32223679NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34885762NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PURPOSE OF THE FOUNDATION IS TO PROMOTE THE HEALTH OF THE CITIZENS OF BOLIVAR COUNTY, MISSISSIPPI.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense480714Expense
Grants480714Grants
DescriptionBOLIVAR COUNTY, MISSISSIPPIDescription
Total Program Service Expense480714TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JACKSON & BRASWELLBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6628431555TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 298AddressLine1
CityCLEVELANDCity
StateMSState
ZIP Code38732ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KENT WYATT
DIRECTOR1.00X000
MAURICE LUCAS
VICE CHAIRMA1.00X000
CANDY DAVIS
DIRECTOR1.00X000
JEANIE WALKER
SECRETARY1.00X000
DARRYL JOHNSON
DIRECTOR1.00X000
MARK HARGETT
CHAIRMAN1.00X000
ROY COLLINS
DIRECTOR1.00X000
NED TOLLIVER
TREASURER1.00X000
BENNIE WRIGHT
DIRECTOR1.00X000
DON BLACKWOOD
DIRECTOR1.00X000
GEORGENNE CLARK
DIRECTOR1.00X000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3392694TotalRevenueColumn
Related Or Exempt Function Income3392694RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities7775992Securities
Other19518Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7862108Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-86116Securities
Other19518Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-66598TotalRevenueColumn
Related Or Exempt Function Income-66598RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Total Revenue Column782TotalRevenueColumn
Related Or Exempt Function Income782RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue782TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3326878TotalRevenueColumn
Related Or Exempt Function Income3326878RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total480714Total
Program Services480714ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total25604Total
Management And General25604ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4202Total
Management And General4202ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
INVESTMENT FEES124790124790
INVESTMENT ADVISOR2400024000
INSURANCE54855485

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total664795Total
Program Services480714ProgramServices
Management And General184081ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY-1EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY169376BOY
EOY115711EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY32145728BOY
EOY34801529EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY244052BOY
EOY304000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32559156BOY
EOY35221239EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY335477BOY
EOY335477EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY335477BOY
EOY335477EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32223679BOY
EOY34885762EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32223679BOY
EOY34885762EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32559156BOY
EOY35221239EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2662083ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Governmental Unit170b1 AvXGovernmentalUnit170b1Av

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR
Total Revenue3326878TotalRevenue
Total Expenses664795TotalExpenses
Excess Or Deficit For Year2662083ExcessOrDeficitForYear
Excess Or Deficit Per FS2662083ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt3326878TotRevenueEtcAuditedFinclStmt
Revenue Subtotal3326878RevenueSubtotal
Total Revenue Per Form9903326878TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt664795TotExpensesEtcAuditedFinclStmt
Expenses Subtotal664795ExpensesSubtotal
Total Expenses Per Form990664795TotalExpensesPerForm990

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
BOLIVAR MEDICAL CENTER
HWY 8CLEVELANDMS38732200000INDIGENT CARE
BOLIVAR MEDICAL CENTER
HWY 8CLEVELANDMS38732135524AMBULATORY CARE
BOLIVAR COUNTY COUNCIL ON AGING
PO BOX 593CLEVELANDMS3873222000ELDERLY TRANSPORTATI
DELTA HEALTH CENTER
702 MARTIN LUTHER KING DRIVEMOUND BAYOUMS38762120000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC

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