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Nonprofiteer
← NORTHWEST MEDICAL CENTER ASSOCIATION INC

Form 990 for tax year 2022

Filed by NORTHWEST MEDICAL CENTER ASSOCIATION INC.

Totals

Total revenue
$23,340,134
Total expenses
$25,713,236
Contributions and grants received
$1,139,977
Grants paid
$7,620
Program service revenue
$21,223,973
Investment income
$198,908
Other revenue
$777,276
Total assets, end of year
$19,905,412
Total liabilities, end of year
$12,908,694
Net assets or fund balances, end of year
$6,996,718
Program services expenses (Part IX)
$21,999,582
Management and general expenses
$3,713,654
Fundraising expenses
$0
Program service expenses (Part III)
$21,999,582

Program services were 85.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $1,128,566

  • 1e · Government grants (contributions)

    $11,411

  • 2a · Program service revenue: Net Patient Service Revenue

    total $19,955,527 · related or exempt $19,955,527

  • 2b · Program service revenue: 340B Pharmacy Revenue

    total $1,268,446 · related or exempt $1,268,446

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $195,908 · excluded $195,908

  • 6a · Gross rents

    real property $1,200

  • 6c · Rental income or loss

    real property $1,200 · personal property $0

  • 6d · Net rental income or loss

    total $1,200 · related or exempt $1,200

  • 7a · Gross sales of assets other than inventory

    other assets $3,000

  • 7b · Less cost or other basis and sales expenses

    other assets $0

  • 7c · Gain or loss

    securities $0 · other assets $3,000

  • 7d · Net gain or loss

    total $3,000 · excluded $3,000

  • 11a · Other revenue: Referral Lab Revenue

    total $88,519 · related or exempt $87,984 · unrelated business $535

  • 11b · Other revenue: Cafeteria

    total $87,753 · related or exempt $87,753

  • 11c · Other revenue: Other Misc Revenue

    total $599,804 · related or exempt $599,804

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $776,076

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $7,620 · program services $7,620

  • 5 · Compensation of officers, directors and key employees

    total $449,605 · program services $121,937 · management and general $327,668 · fundraising $0

  • 7 · Other salaries and wages

    total $9,822,096 · program services $9,537,177 · management and general $284,919

  • 8 · Pension plan contributions

    total $245,473 · program services $239,931 · management and general $5,542

  • 9 · Other employee benefits

    total $1,678,168 · program services $1,525,340 · management and general $152,828

  • 10 · Payroll taxes

    total $665,240 · program services $627,288 · management and general $37,952

  • 11d · Fees: lobbying

    total $8,516 · management and general $8,516

  • 11g · Fees: other

    total $1,403,248 · program services $1,333,618 · management and general $69,630 · fundraising $0

  • 12 · Advertising and promotion

    total $655 · management and general $655

  • 13 · Office expenses

    total $1,732,212 · program services $1,697,077 · management and general $35,135

  • 14 · Information technology

    total $480,430 · program services $480,430

  • 16 · Occupancy

    total $356,374 · program services $330,142 · management and general $26,232

  • 17 · Travel

    total $36,878 · program services $33,501 · management and general $3,377

  • 19 · Conferences, conventions and meetings

    total $4,451 · program services $4,451

  • 20 · Interest

    total $145,460 · program services $7,585 · management and general $137,875

  • 22 · Depreciation, depletion and amortization

    total $1,682,370 · program services $1,119,255 · management and general $563,115

  • 23 · Insurance

    total $191,892 · program services $191,892

  • 24a · Other expenses: Corporate Allocations From Mosaic Health System

    total $3,557,909 · program services $1,529,901 · management and general $2,028,008

  • 24b · Other expenses: Medical Supplies/Includes 340B

    total $2,480,125 · program services $2,480,125

  • 24c · Other expenses: FRA Tax

    total $711,120 · program services $711,120

  • 24d · Other expenses: Dues & Subscriptions

    total $53,394 · program services $21,192 · management and general $32,202

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $9,985 · end of year $10,691

  • 4 · Accounts receivable

    beginning of year $2,586,459 · end of year $3,592,142

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $191,931 · end of year $155,020

  • 9 · Prepaid expenses and deferred charges

    beginning of year $290,313 · end of year $271,516

  • 10a · Land, buildings and equipment: cost or other basis

    $16,754,689

  • 10b · Land, buildings and equipment: accumulated depreciation

    $5,938,426

  • 10c · Land, buildings and equipment, net

    beginning of year $11,341,062 · end of year $10,816,263

  • 11 · Investments: publicly traded securities

    beginning of year $4,348,971 · end of year $4,487,443

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $117,415 · end of year $119,689

  • 15 · Other assets

    beginning of year $2,891,780 · end of year $452,648

  • 17 · Accounts payable and accrued expenses

    beginning of year $5,520,160 · end of year $5,614,580

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $7,023,456 · end of year $7,294,114

  • 27 · Net assets without donor restrictions

    beginning of year $7,597,007 · end of year $6,487,040

  • 28 · Net assets with donor restrictions

    beginning of year $1,637,293 · end of year $509,678

Mission and programs · 2022

Mission

WITH THE HELP OF TRUSTED, INTEGRATED PARTNERS, NORTHWEST MEDICAL CENTER SERVES AS A COMPASSIONATE, EFFICIENT HEALTH HOME THAT ENCOURAGES WELLNESS, RESTORES HEALTH AND PROMOTES A SUPERIOR QUALITY OF LIFE.

Activities or mission (Part I)

NORTHWEST MEDICAL CENTER SERVES AS A COMPASSIONATE, EFFICIENT HEALTH HOME THAT ENCOURAGES WELLNESS, RESTORES HEALTH, AND PROMOTES A SUPERIOR QUALITY OF LIFE.

  • Northwest Medical Center Association (Mosaic-Albany) is a critical access hospital located in Albany, Missouri, and operates clinics in Albany, Grant City, New Hampton, and Stanberry. Its primary service area is predominantly rural and includes Gentry and Worth counties located in northwest Missouri. According to the 2022 U.S. census estimates, the population in the two-county service area is approximately 8,208, which includes a high percentage of low-income families. The economy of the region is based on agriculture, minor manufacturing and small businesses resulting in a payor mix for Mosaic-Albany approximately 72.63% governmental or self-pay patients. 15.6% of the population have an income that is below the federal poverty level. Mosaic-Albany offers both inpatient and outpatient services including emergency care, plus convenient clinics, and specialty care services. During the year, approximately 536 patients were admitted to the hospital resulting in approximately 1,891 patient days. The emergency room served approximately 2,682 patients and approximately 12,663 clinic visits were generated. We seek to improve the health of area individuals and communities. The Organization is a member of the Mayo Network for clinical consultations.

    Expenses $21,999,582 · Grants $7,620 · Revenue $22,000,714

As filed on the 2022 return.

Listed in Part VII

  • John M Poore

    Director/CEO

    Total calculated
    $661,497
    From this org
    $0
    From related orgs
    $646,385
    Other
    $15,112
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $630,107 related
    Bonus
    $0 + $13,827 related
    Other
    $0 + $2,451 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $15,112 related
    Filer's total
    $0 + $661,497 related

  • Thomas Bieterman

    Former Director/CFO

    Total calculated
    $169,989
    From this org
    $0
    From related orgs
    $167,017
    Other
    $2,972
    Hours/week
    1 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $166,756 related
    Bonus
    $0 + $261 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $2,972 related
    Filer's total
    $0 + $169,989 related

  • Davin Turner DO

    Director

    Total calculated
    $414,592
    From this org
    $0
    From related orgs
    $393,638
    Other
    $20,954
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $354,867 related
    Bonus
    $0 + $35,973 related
    Other
    $0 + $2,798 related
    Deferred
    $0 + $8,299 related
    Nontaxable benefits
    $0 + $12,655 related
    Filer's total
    $0 + $414,592 related

  • Gene A Claycomb

    Director

    Total calculated
    $489,917
    From this org
    $0
    From related orgs
    $443,355
    Other
    $46,562
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $344,147 related
    Bonus
    $0 + $94,682 related
    Other
    $0 + $4,526 related
    Deferred
    $0 + $10,588 related
    Nontaxable benefits
    $0 + $35,974 related
    Filer's total
    $0 + $489,917 related

  • Matt Baker

    Director/Vice Chair

    Total calculated
    $2,500
    From this org
    $0
    From related orgs
    $2,500
    Other
    $0
    Hours/week
    1 + 3 related

  • Serena Naylor

    Director/Chair

    Total calculated
    $2,500
    From this org
    $0
    From related orgs
    $2,500
    Other
    $0
    Hours/week
    1 + 4 related

  • Drew Keesbury

    CFO/Treasurer

    Total calculated
    $0
    Hours/week
    1 + 36 related

  • Katie Dias DO

    Administrator - MLC Albany

    Total calculated
    $355,611
    From this org
    $327,416
    From related orgs
    $0
    Other
    $28,195
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $255,779
    Bonus
    $70,980
    Other
    $657
    Deferred
    $9,648
    Nontaxable benefits
    $18,547
    Filer's total
    $355,611

  • Michael R Rinard

    Secretary

    Total calculated
    $315,515
    From this org
    $0
    From related orgs
    $273,849
    Other
    $41,666
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $213,676 related
    Bonus
    $0 + $58,812 related
    Other
    $0 + $1,361 related
    Deferred
    $0 + $9,254 related
    Nontaxable benefits
    $0 + $32,412 related
    Filer's total
    $0 + $315,515 related

  • Angelia Martin MD

    Staff Physician

    Total calculated
    $311,907
    From this org
    $271,556
    From related orgs
    $2,500
    Other
    $37,851
    Hours/week
    37 + 3 related

    Schedule J breakdown matched by us

    Base
    $268,953 + $2,500 related
    Bonus
    $36
    Other
    $2,567
    Deferred
    $5,627
    Nontaxable benefits
    $32,224
    Filer's total
    $309,407 + $2,500 related

  • Evan R Slanczka

    Staff Physician

    Total calculated
    $464,661
    From this org
    $444,063
    From related orgs
    $0
    Other
    $20,598
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $384,160
    Bonus
    $58,449
    Other
    $1,454
    Deferred
    $8,296
    Nontaxable benefits
    $12,302
    Filer's total
    $464,661

  • James Bartley DO

    Staff Physician

    Total calculated
    $354,020
    From this org
    $313,151
    From related orgs
    $0
    Other
    $40,869
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $311,243
    Bonus
    $0
    Other
    $1,908
    Deferred
    $9,657
    Nontaxable benefits
    $31,212
    Filer's total
    $354,020

  • Lori L Bishop

    Director - Nursing Services - Albany

    Total calculated
    $154,980
    From this org
    $132,930
    From related orgs
    $0
    Other
    $22,050
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $111,507
    Bonus
    $20,800
    Other
    $623
    Deferred
    $2,734
    Nontaxable benefits
    $19,316
    Filer's total
    $154,980

  • Renee L Ellis

    Inpatient RN - Albany

    Total calculated
    $139,375
    From this org
    $127,143
    From related orgs
    $0
    Other
    $12,232
    Hours/week
    40

  • Dwain Stilson

    Former CFO/Treasurer

    Total calculated
    $163,042
    From this org
    $0
    From related orgs
    $157,969
    Other
    $5,073
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $157,169 related
    Bonus
    $0 + $550 related
    Other
    $0 + $250 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $5,073 related
    Filer's total
    $0 + $163,042 related

  • Karen S Miller

    Former Treasurer

    Total calculated
    $191,840
    From this org
    $0
    From related orgs
    $179,091
    Other
    $12,749
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $178,284 related
    Bonus
    $0
    Other
    $0 + $807 related
    Deferred
    $0 + $7,236 related
    Nontaxable benefits
    $0 + $5,513 related
    Filer's total
    $0 + $191,840 related

  • Mark Laney MD

    Former Director/CEO

    Total calculated
    $3,059,649
    From this org
    $0
    From related orgs
    $3,032,113
    Other
    $27,536
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $3,027,894 related
    Bonus
    $0 + $228 related
    Other
    $0 + $3,991 related
    Deferred
    $0 + $8,220 related
    Nontaxable benefits
    $0 + $19,316 related
    Filer's total
    $0 + $3,059,649 related

  • Michael Pulido

    Former Secretary/Chair

    Total calculated
    $1,292,933
    From this org
    $0
    From related orgs
    $1,258,302
    Other
    $34,631
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $1,255,487 related
    Bonus
    $0
    Other
    $0 + $2,815 related
    Deferred
    $0 + $8,102 related
    Nontaxable benefits
    $0 + $26,529 related
    Filer's total
    $0 + $1,292,933 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 4a Severance or change-of-control payment
Mosaic Health System, a related organization, paid Samuel Mark Laney, CEO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation. Mosaic Health System, a related organization, paid Michael Pulido, COO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
JOHN M POORE - VESTED $0; ACCRUED $116,667 GENE A CLAYCOMB - VESTED $0; ACCRUED $50,400 DAVIN TURNER, DO - VESTED $0; ACCRUED $21,000 MICHAEL R RINARD - VESTED $0; ACCRUED $31,360 THOSE LISTED ABOVE HAVE SIGNED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH RECOGNIZES THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN. THE FOLLOWING ARE THE GENERAL STIPULATIONS OF THE AGREEMENT: 1. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT, WHICH WILL REWARD THE INDIVIDUAL WITH 100% VESTING BASED ON A 5-YEAR CLIFF VESTING SCHEDULE. 2. FOR SERP PARTICIPANTS PRIOR TO 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATIONFROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT WILL BE DISBURSED WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. 3. FOR SERP PARTICIPANTES AFTER 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT DISTRIBUTES WITHIN 60 DAYS AND DOESN'T TAKE INTO ACCOUNT NON-COMPETE COVENANT. 4. SEPARATION WITH CAUSE MAKES THE SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENT NULL AND VOID.
Schedule J, Part I, Line 3 Compensation Plan
COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY, USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEYS OR STUDIES 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • ST JOSEPH DOWNTOWN DEVELOPMENT LLC

    N/A · DEVELOPMENT OF DOWNTOWN ST. JOSEPH · MO

    Directly controlled by NA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • Midwestern Health Management Inc

    C Corporation · Healthcare · MO · controlled entity

    Directly controlled by NA

  • HHS Properties Inc

    C Corporation · Investment · MO · controlled entity

    Directly controlled by NA

  • Uptown Housing Inc

    C Corporation · Redevelopment · MO · controlled entity

    Directly controlled by NA

  • Uptown St Joseph Redevelopment Corp

    C Corporation · Redevelopment · MO · controlled entity

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2022
Filed
8 May 2024
IRS schema version
2022v5.0
Source object
202411299349303521

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