THE MEDICAL CENTER AT CLINTON COUNTY INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- THE MEDICAL CENTER AT CLINTON COUNTY INC (EIN 81-1312058)
- Tax period
- 2022-04-01 to 2023-03-31
- Filed
- 2024-02-14
- IRS object ID
- 202400459349300330
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-02-14T08:50:14-06:00 | ReturnTs |
| Tax Period End | 2023-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1222 Demonbreun Street Suite 950 | AddressLine1Txt |
| City | Nashville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 372033357 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 811312058 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEDICAL CENTER AT CLINTON COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JENNY GREENWELL | InCareOfNm |
| Business Name Control | MEDI | BusinessNameControlTxt |
| Phone | 2707451551 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 PARK STREET | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELE LAWLESS | PersonNm |
| Person Title | EVP - CFO | PersonTitleTxt |
| Phone | 2707451551 | PhoneNum |
| Signature | 2024-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHELE | PersonFirstNm |
| Person Last | LAWLESS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF SMITH | PreparerPersonNm |
| PTIN | P00289876 | PTIN |
| Phone | 6159883600 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEDICAL CENTER AT ALBANY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CONNIE D SMITH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 PARK STREET | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,015,565 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://MEDCENTERHEALTH.ORG/LOCATIONS/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2016 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | PROVIDES INPATIENT AND OUTPATIENT ACUTE CARE SERVICES BY OR UNDER THE SUPERVISION OF PHYSICIANS IN ALBANY, KENTUCKY AND IN THE SURROUNDING COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 117 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $388,534 | PYContributionsGrantsAmt |
| CY Contributions Grants | $751,475 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,554,667 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,701,958 | CYProgramServiceRevenueAmt |
| PY Investment Income | $131,455 | PYInvestmentIncomeAmt |
| CY Investment Income | $161 | CYInvestmentIncomeAmt |
| PY Other Revenue | $504,832 | PYOtherRevenueAmt |
| CY Other Revenue | $561,971 | CYOtherRevenueAmt |
| PY Total Revenue | $13,579,488 | PYTotalRevenueAmt |
| CY Total Revenue | $16,015,565 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,051,784 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,743,763 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,798,466 | PYOtherExpensesAmt |
| CY Other Expenses | $9,750,264 | CYOtherExpensesAmt |
| PY Total Expenses | $14,850,250 | PYTotalExpensesAmt |
| CY Total Expenses | $16,494,027 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,270,762 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$478,462 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,891,924 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,478,404 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,695,375 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,760,317 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,196,549 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,718,087 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DEDICATED TO PROVIDING THE HIGHEST QUALITY CARE POSSIBLE IN A SAFE AND SECURE ENVIRONMENT; COMMITTED TO THE PROMOTION OF WELLNESS AND RESTORATION OF HEALTH IN A COST-EFFECTIVE MANNER; CONTINUOUSLY STRIVE TO IMPROVE THE QUALITY OF HEALTH IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,008,108 | ExpenseAmt |
| Revenue | $11,743,473 | RevenueAmt |
| Desc | OUTPATIENT SERVICES: THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY (MCA) IS RECOGNIZED BY MEDICARE AS AN ACUTE CARE HOSPITAL. THE HOSPITAL SERVES THE COMMUNITY BY PROVIDING CERTAIN OUTPATIENT SERVICES, INCLUDING AN EMERGENCY DEPARTMENT, BY OR UNDER THE SUPERVISION OF PHYSICIANS, DIAGNOSTIC AND THERAPEUTIC SERVICES FOR MEDICAL DIAGNOSIS, TREATMENT, CARE, OR REHABILITATION OF INJURED, DISABLED, OR SICK PERSONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,773,227 | ExpenseAmt |
| Revenue | $2,958,485 | RevenueAmt |
| Desc | INPATIENT SERVICES: MCA IS A 42-BED ACUTE CARE HOSPITAL ENGAGED IN PROVIDING INPATIENT SERVICES, BY OR UNDER THE SUPERVISION OF PHYSICIANS, DIAGNOSTIC, AND THERAPEUTIC SERVICES FOR MEDICAL DIAGNOSIS, TREATMENT, CARE, OR REHABILITATION OF INJURED, DISABLED, OR SICK PERSONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $13,781,335 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 117 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNY GREENWELL | PersonNm |
| Phone | 2707451551 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 PARK STREET | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42101 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MS CONNIE D SMITH | |||||||||
| PRESIDENT / CEO | 2.0 | 52.0 | Yes (X) | Yes (X) | $0 | $1,285,993 | $20,191 | ||
| MR WADE STONE | |||||||||
| EXECUTIVE VICE PRESIDENT | 2.0 | 50.0 | Yes (X) | $0 | $501,132 | $20,005 | |||
| MR DAVID GRAY | |||||||||
| EXECUTIVE VICE PRESIDENT | 2.0 | 50.0 | Yes (X) | $0 | $385,152 | $43,999 | |||
| MS MICHELE W LAWLESS | |||||||||
| EXECUTIVE VICE PRESIDENT/CFO | 2.0 | 50.0 | Yes (X) | $0 | $421,749 | $3,491 | |||
| MR ERIC HAGAN | |||||||||
| VP OF RURAL HOSPITALS | 4.0 | 36.0 | $29,605 | $266,447 | $19,958 | Yes (X) | |||
| MS KATRINA WOOD | |||||||||
| VP/CHIEF NURSING OFFICER | 2.0 | 50.0 | Yes (X) | $0 | $219,378 | $35,340 | |||
| MS LAURA BELCHER | |||||||||
| VICE PRESIDENT/ADMINISTRATOR | 40.0 | 0.0 | $161,067 | $0 | $40,260 | Yes (X) | |||
| MS LORI POINDEXTER | |||||||||
| APRN | 40.0 | 0.0 | $107,931 | $0 | $33,474 | Yes (X) | |||
| MS AMY CLABORN | |||||||||
| DIRECTOR OF PATIENT CARE SVCS | 40.0 | 0.0 | $114,887 | $0 | $13,432 | Yes (X) | |||
| MS SHEILA KINGRY | |||||||||
| PHARMACY MANAGER | 40.0 | 0.0 | $111,646 | $0 | $8,749 | Yes (X) | |||
| DR PAUL COOK | |||||||||
| CHAIR | 2.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DR DONNA BLACKBURN | |||||||||
| VICE CHAIR | 2.0 | 4.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MR TOMMY LOVING | |||||||||
| SECRETARY | 2.0 | 4.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DR KAL SAHETYA | |||||||||
| DIRECTOR | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $525,136 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,079,851 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $238,899 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DIAGNOSTIC SHARED SERVICES | |||||
| 2650 EASTPOINT PARKWAY STE 300 | LOUISVILLE | KY | 40223 | CLINICAL SERVICES | $129,150 |
| SOUTHEASTERN EMERGENCY PHYSICIANS | |||||
| PO BOX 634850 | CINCINNATI | OH | 452634850 | ER PHYSICIAN SVCS | $944,060 |
| HEARTCARE IMAGING INC | |||||
| 760 NORTH US HWY ONE | TEQUESTA | FL | 33469 | CLINICAL SERVICES | $158,428 |
| QUALIVIS LLC | |||||
| DEPARTMENT 3847 PO BOX 123847 | DALLAS | TX | 75312 | STAFFING SERVICES | $311,049 |
| COMPUTER PROGRAMS AND SYSTEMS INC | |||||
| PO BOX 850309 | MOBILE | AL | 366850309 | PROFESSIONAL FEES | $152,808 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $10,992 | RelatedOrganizationsAmt |
| Government Grants | $740,483 | GovernmentGrantsAmt |
| Total Contributions | $751,475 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OUTPATIENT SERVICES | 621400 | $11,743,473 | $11,743,473 |
| INPATIENT ROUTINE AND ANCILLARY SERVICES | 621110 | $2,958,485 | $2,958,485 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,701,958 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $161 | TotalRevenueColumnAmt |
| Exclusion | $161 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $48,983 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $48,983 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,983 | TotalRevenueColumnAmt |
| Exclusion | $48,983 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CONTRACT LABOR | 900099 | $358,976 | $358,976 |
| CAFETERIA/FOOD SERVICE | 722514 | $24,355 | $24,355 |
| OTHER MISCELLANEOUS REVENUE | 900099 | $129,657 | $129,657 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $512,988 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,015,565 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,701,958 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $562,132 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,928 | TotalAmt |
| Management And General | $232,928 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,023,855 | TotalAmt |
| Program Services | $4,930,718 | ProgramServicesAmt |
| Management And General | $93,137 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,841 | TotalAmt |
| Program Services | $149,926 | ProgramServicesAmt |
| Management And General | $9,915 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $935,231 | TotalAmt |
| Program Services | $877,221 | ProgramServicesAmt |
| Management And General | $58,010 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,908 | TotalAmt |
| Program Services | $367,508 | ProgramServicesAmt |
| Management And General | $24,400 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,197,807 | TotalAmt |
| Program Services | $163,407 | ProgramServicesAmt |
| Management And General | $1,034,400 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,745 | TotalAmt |
| Management And General | $48,745 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,615 | TotalAmt |
| Management And General | $72,615 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,575,883 | TotalAmt |
| Program Services | $2,240,573 | ProgramServicesAmt |
| Management And General | $335,310 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,787 | TotalAmt |
| Program Services | $983 | ProgramServicesAmt |
| Management And General | $19,804 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,155,207 | TotalAmt |
| Program Services | $661,137 | ProgramServicesAmt |
| Management And General | $494,070 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,555 | TotalAmt |
| Program Services | $359,555 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,487 | TotalAmt |
| Program Services | $572,487 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,595 | TotalAmt |
| Program Services | $18,326 | ProgramServicesAmt |
| Management And General | $27,269 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $795,749 | TotalAmt |
| Program Services | $553,059 | ProgramServicesAmt |
| Management And General | $242,690 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,439 | TotalAmt |
| Program Services | $117,624 | ProgramServicesAmt |
| Management And General | $3,815 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,651,132 | $1,651,132 | |
| PHYSICIAN PRACTICE EXPENSE | $508,610 | $508,610 | |
| PROVIDER TAX | $574,384 | $574,384 | |
| OTHER TAXES & LICENSES | $2,114 | $49 | $2,065 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,155 | TotalAmt |
| Program Services | $34,636 | ProgramServicesAmt |
| Management And General | $13,519 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,494,027 | TotalAmt |
| Program Services | $13,781,335 | ProgramServicesAmt |
| Management And General | $2,712,692 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $302,980 | BOYAmt |
| EOY | $825,437 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,178,256 | BOYAmt |
| EOY | $1,404,202 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,287 | BOYAmt |
| EOY | $450,685 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,565 | BOYAmt |
| EOY | $151,247 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,024,105 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,082,834 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,367,094 | BOYAmt |
| EOY | $7,941,271 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,910 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,265,832 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $705,562 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,891,924 | BOYAmt |
| EOY | $11,478,404 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,166,025 | BOYAmt |
| EOY | $1,746,868 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $529,350 | BOYAmt |
| EOY | $1,013,449 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,695,375 | BOYAmt |
| EOY | $2,760,317 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,196,549 | BOYAmt |
| EOY | $8,718,087 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,196,549 | BOYAmt |
| EOY | $8,718,087 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,891,924 | BOYAmt |
| EOY | $11,478,404 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$478,462 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $200,200 | OtherCostOrOtherBasisAmt |
| Book Value | $200,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,404,229 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,214,549 | DepreciationAmt |
| Book Value | $6,189,680 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,419,676 | OtherCostOrOtherBasisAmt |
| Depreciation | $868,285 | DepreciationAmt |
| Book Value | $1,551,391 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $7,941,271 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| AMOUNTS DUE FROM MEDICARE | $705,040 |
| RECEIVABLES FROM AFFILIATES | $522 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $705,562 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYABLE TO AFFILIATES | Desc |
| Amt | $1,013,449 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,013,449 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $16,015,565 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $16,015,565 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $16,015,565 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,494,027 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $16,494,027 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $16,494,027 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | INCOME TAXES --------------- THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A FOOTNOTE THAT ADDRESSED THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN48 (ASC 740). 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 116 | PersonsServedCnt |
| Total Community Benefit Expns | $45,612 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $303,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 116 | PersonsServedCnt |
| Total Community Benefit Expns | $45,612 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $303,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 9 | PersonsServedCnt |
| Total Community Benefit Expns | $63,815 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $500 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 9 | PersonsServedCnt |
| Total Community Benefit Expns | $64,315 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $64,315 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 125 | PersonsServedCnt |
| Total Community Benefit Expns | $109,927 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $368,227 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02340 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100 | NetCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $20,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $20,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,138,642 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $373,891 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,725,076 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,907,771 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,182,695 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEDICAL CENTER AT CLINTON COUNTY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 723 BURKESVILLE ROAD | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42602 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://MEDCENTERHEALTH.ORG/LOCATIONS/ | WebsiteAddressTxt |
| State License | 100078 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEDICAL CENTER AT CLINTON COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT ---------------- THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY (MCA) CONTRACTED WITH THE COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK) IN THE FALL OF 2020 TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE HOSPITAL. THE ASSESSMENT PROCESS INCLUDED COLLECTING SECONDARY DATA RELATED TO THE HEALTH OF THE COMMUNITY. SOCIAL AND ECONOMIC DATA AS WELL AS HEALTH OUTCOMES AND PROVIDERS DATA WERE COLLECTED FROM SECONDARY SOURCES TO HELP PROVIDE DEMOGRAPHIC CONTEXT FOR THE COMMUNITY. IN ADDITION, CEDIK COMPILED HOSPITAL UTILIZATION DATA TO BETTER UNDERSTAND WHO WAS USING THE FACILITY AND FOR WHAT SERVICES. FINALLY, WITH THE ASSISTANCE OF THE STEERING COMMITTEE, INPUT FROM THE COMMUNITY WAS COLLECTED THROUGH KEY INFORMATION INTERVIEWS AND SURVEYS. TO FORM A STEERING COMMITTEE, CEDIK PROVIDED A LIST OF COMMUNITY LEADERS, AGENCIES AND ORGANIZATIONS TO ASSIST MCA IN THE RECRUITMENT OF MEMBERS THAT WOULD FACILITATE BROAD COMMUNITY INPUT. THESE COMMITTEE MEMBERS REPRESENT ORGANIZATIONS AND AGENCIES THAT SERVE THE CLINTON COUNTY POPULATION IN A VARIETY OF AREAS THAT RELATE TO A POPULATION'S HEALTH. BY VOLUNTEERING THEIR TIME, THE COMMITTEE MEMBERS ENABLED THE HOSPITAL TO ACQUIRE INPUT FROM RESIDENTS THAT ARE OFTEN NOT ENGAGED IN CONVERSATIONS ABOUT THEIR HEALTH NEEDS. THE STEERING COMMITTEE PROVIDED BOTH AN EXPERT VIEW OF THE NEEDS THEY SEE WHILE WORKING WITH THE PEOPLE AND CLIENTS THEY SERVE AND IN EXTENSIVE DISTRIBUTION OF THE COMMUNITY SURVEY. TWELVE MEMBERS OF THE CLINTON COUNTY HEALTH COALITION PARTICIPATED IN A FOCUS GROUP FOR THE 2022 CHNA. THE COALITION MEMBERSHIP INCLUDED REPRESENTATION FROM THE HEALTH DEPARTMENT, BEHAVIORAL HEALTH, PUBLIC SCHOOLS, FAMILY RESOURCE CENTERS, COOPERATIVE EXTENSION, REGIONAL CANCER PREVENTION AND COMMUNITY-BASED SERVICES. IN ADDITION, SEVEN STEERING COMMITTEE MEMBERS PARTICIPATED IN EITHER A FOCUS GROUP OR AN INDIVIDUAL INTERVIEW TO IDENTIFY CURRENT HEALTH NEEDS, BARRIERS TO HEALTH CARE, AND DISCUSS SOCIAL DETERMINANTS OF HEALTH. |
| SCHEDULE H, PART V, SECTION B, LINE 6B | OTHER ORGANIZATION ---------------------- THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WAS PREPARED FOR THE MEDICAL CENTER AT ALBANY, CLINTON COUNTY, KENTUCKY BY THE COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK) AT THE UNIVERSITY OF KENTUCKY. THE CHNA WAS NOT CONDUCTED WITH OTHER HOSPITAL FACILITIES. |
| SCHEDULE H, PART V, SECTION B, LINE 7A & 10A | AVAILABILITY TO THE PUBLIC ------------------------------------- A COPY OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND STRATEGIC IMPLEMENTATION PLAN CAN BE FOUND AT: HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| SCHEDULE H, PART V, SECTION B, LINE 11 | ADDRESSING NEEDS ----------------- THE CHNA STEERING COMMITTEE MET TO REVIEW FINDINGS FROM THE 2021 MEDICAL CENTER AT ALBANY CHNA INCLUDING THE COMMUNITY SURVER RESULTS, ADDITIONAL PRIMARY DATA (KEY INFORMANT INTERVIEWS AND FOCUS GROUPS) AND ADDITIONAL 2021 COUNTY SPECIFIC SECONDARY DATA. CEDIK STAFF LED A FACILITATED DISCUSSION WITH STEERING COMMITTEE MEMBERS TO COMPLETE THE PROCESS OF PRIORITIZING THE IDENTIFIED HEALTH NEEDS. THE PROCESS OF PRIORITY SELECTION CONSIDERED THE FOLLOWING FACTORS: 1) THE ABILITY OF MCA TO EVALUATE AND MEASURE OUTCOMES 2) THE NUMBER OF PEOPLE AFFECTED BY THE ISSUE OR SIZE OF THE ISSUE 3) THE CONSEQUENCES OF NOT ADDRESSING THIS PROBLEM 4) PREVALENCE OF COMMON THEMES 5) THE EXISTENCE OF HOSPITAL PROGRAMS WHICH RESPOND TO THE IDENTIFIED NEED. NEEDS NOT ADDRESSED --------------------- MENTAL HEALTH SERVICES ARE OUTSIDE OF THE RESOURCES THAT MCA IS ABLE TO PROVIDE WITH THE RESOURCES AVAILABLE. MCA WILL CONTINUE TO MAINTAIN EXISTING AND ESTABLISH NEW RELATIONSHIPS OF ENTITIES PROVIDING BEHAVIORAL HEALTH TREATMENT THAT CAN BE BENEFICIAL FOR THE PLACEMENT AND REFERRAL FOR MCA PATIENTS AND FAMILIES. MCA KICKED OFF THE IMPLEMENTATION STRATEGY BY INITIATING COLLABORATIVE EFFORTS WITH COMMUNITY LEADERS. MCA CONDUCTS PERIODIC EVALUATIONS OF GOALS/OBJECTIVES FOR EACH PRIORITY IDENTIFIED. |
| SCHEDULE H, PART V, SECTION B, LINE 13B & 13H | LINE 13B: ELIGIBILITY CRITERIA - INCOME OTHER THAN FPG ---------------------------------------------- BECAUSE THERE MAY BE CIRCUMSTANCES WHERE A PATIENT/GUARANTOR MAY END UP OWING AN AMOUNT THAT IS LARGE IN RELATION TO HIS INCOME, BUT STILL NOT MEET OUR STANDARD FINANCIAL ASSISTANCE (CHARITY CARE) GUIDELINES, AND BECAUSE WE DO NOT WANT TO CREATE WHAT IS COMMONLY KNOWN AS "MEDICAL INDIGENCY," WE WILL ALSO APPLY THE FOLLOWING GUIDELINES TO FINANCIAL ASSISTANCE APPLICATIONS: 1) ONLY PERSONS OR FAMILIES WHO MAKE LESS THAN 20 TIMES (2000%) OF THE SINGLE PERSON FPL ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE. THE PURPOSE OF THIS REQUIREMENT IS TO LIMIT THE INCENTIVE TO NOT PURCHASE HEALTH INSURANCE IF A PERSON CAN AFFORD IT. 2) A SELF-PAY PORTION OF A BILL GREATER THAN 20% OF ANNUAL INCOME QUALIFIES A PERSON FOR CATASTROPHIC FINANCIAL ASSISTANCE. 3) THE AMOUNT DUE FROM CATASTROPHIC FINANCIAL ASSISTANCE APPLICANTS IS CAPPED AT 50% OF THEIR DOCUMENTED AND VERIFIED ANNUAL INCOME PLUS THE AMOUNT THE PATIENT'S LIQUID ASSETS EXCEED THEIR IMMEDIATE NEEDS AS DEFINED IN OUR FINANCIAL ASSISTANCE POLICY. 4) WE WILL ALLOW PAYMENT OF THIS CAPPED AMOUNT OVER A PERIOD OF UP TO 10 YEARS, WITH UP TO 15 YEARS AVAILABLE WITH THE APPROVAL OF THE DIRECTOR OF REVENUE CYCLE. 5) THE PAYMENTS WILL BE TREATED AS LONG-TERM PAY, I.E. THEY WILL REQUIRE A WRITTEN AGREEMENT, AND THE PAYMENTS WILL BE INTEREST FREE FOR THE REMAINING PORTION OF THE BALANCE DUE. LINE 13H: ELIGIBILITY CRITERIA - OTHER -------------------------------- PERSONS OR FAMILIES THAT QUALIFY FOR MEDICAID, FOOD STAMPS, AND OTHER INDIGENT CARE PROGRAMS THAT CAN BE AND ARE INDEPENDENTLY VERIFIED WILL BE DEEMED TO MEET THE FINANCIAL ASSISTANCE GUIDELINES, AS WILL ACCOUNTS IDENTIFIED THROUGH TOOLS OR PROGRAMS WHICH PROVIDE REASONABLE ASSURANCE THAT THE ACCOUNT MEETS OUR FINANCIAL ASSISTANCE GUIDELINES. PATIENT ACCOUNTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THE PATIENT HAS BEEN MEDICAID ELIGIBLE WITHIN 60 DAYS BEFORE OR AFTER THE DISCHARGE DATE/DATE OF SERVICE. |
| SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C | FAP WEBSITE -------------- A COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP CAN BE FOUND AT: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/ |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | DETERMINING ELIGIBILITY ------------------------------ THE INCOME LIMIT FOR FINANCIAL ASSISTANCE IS 200% OF THE FEDERAL POVERTY LEVEL. DISCOUNTS ARE PROVIDED TO ALL PATIENTS WHO ARE UNINSURED WHOSE INCOME EXCEEDS THE LIMITS TO QUALIFY FOR FINANCIAL ASSISTANCE. SELF-PAY DISCOUNTS ARE NOT LIMITED BASED ON INCOME. THE HOSPITAL ALSO PROVIDES PAYMENT PLANS FOR SELF-PAY PATIENTS. THE ORGANIZATION ALSO USES ASSET LEVELS, UNINSURED, UNDERINSURED, MCD ELIGIBILITY, FOOD STAMP ELIGIBILITY, AND PROVIDES FOR CATASTROPHIC DISCOUNTS. SEE THE NARRATIVES FOR LINES 13B AND 13H FOR MORE DETAIL. |
| SCHEDULE H, PART I, LINE 6A | COMMUNITY BENEFIT REPORT ------------------------- THE ANNUAL REPORT TO THE COMMUNITY IS POSTED ON THE COMMONWEALTH HEALTH CORPORATION'S WEBSITE AT: HTTPS://MEDCENTERHEALTH.ORG/ABOUT-US/ |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY ---------------------------- THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. THE COSTS RELATED TO MEDICAID PATIENTS WERE ALSO DETERMINED USING A RATIO OF COST TO CHARGE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. |
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE --------------------------- TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990. |
| SCHEDULE H, PART II | COMMUNITY BUILDING ACTIVITIES ------------------------------ COMMUNITY BUILDING ACTIVITIES INCLUDE PARTICIPATION IN CHAMBER OF COMMERCE AND INDUSTRIAL AUTHORITY. |
| SCHEDULE H, PART III, LINE 2 | BAD DEBT EXPENSE -------------------- THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED MARCH 31, 2023. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. |
| SCHEDULE H, PART III, LINE 3 | BAD DEBTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE --------------------------------------------------------------- THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN FINANCIAL ASSISTANCE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THESE REASONS, THE HOSPITAL BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, AND THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS NEGLIGIBLE. |
| SCHEDULE H, PART III, LINE 4 | BAD DEBT EXPENSE FOOTNOTE --------------------------------- THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THE HOSPITAL ELECTED TO EARLY ADOPT ASU 2011-07 ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE FOR FINANCIAL REPORTING PURPOSES. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE SURPLUS/(SHORTFALL) -------------------------------- COSTS REPORTED ON LINE 6 ARE OBTAINED FROM THE MEDICARE COST REPORT WHICH ARE BASED ON A COST TO CHARGE RATIO. |
| SCHEDULE H, PART III, LINE 9B | DEBT COLLECTION PRACTICES --------------------------------- MCA PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE MCA DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, REVENUE IS NOT RECORDED FOR SUCH SERVICES. MCA MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF FINANCIAL ASSISTANCE THEY PROVIDE. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THEIR FINANCIAL ASSISTANCE POLICY. OTHER COMPENSATED CARE RELATES PRINCIPALLY TO CONTRACTUAL ALLOWANCES FOR GOVERNMENT PAYERS, DISCOUNTS TAKEN BY COMMERCIAL PAYERS AND BAD DEBTS. BENEFITS FOR THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES OR WHO ARE UNINSURED. THIS INCLUDES TRADITIONAL FINANCIAL ASSISTANCE AT STANDARD BILLING RATES. MCA DOES NOT PURSUE THE COLLECTION OF AMOUNTS DETERMINED TO BE TRADITIONAL FINANCIAL ASSISTANCE. THEREFORE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT ------------------------------ MCA IS BUILT UPON THE FOUNDATION OF SERVING OUR COMMUNITY, DAY IN AND DAY OUT, WITH QUALITY DEPENDABLE HEALTHCARE. MCA'S CHNA IS POSTED AT: HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ---------------------------------------------------- UPON REGISTRATION, PATIENTS ARE PROVIDED A PATIENT HANDBOOK WHICH CONTAINS INFORMATION REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, SIGNAGE AND BROCHURES DESCRIBING FINANCIAL ASSISTANCE POLICIES ARE AVAILABLE IN ADMISSIONS AREAS. EACH PATIENT RECEIVES A STATEMENT REFERRED TO AS A FIRST NOTICE. THE FIRST NOTICE STATES THAT IT IS NOT A BILL, BUT IT IS A SUMMARY OF THE PATIENT'S CHARGES. THIS NOTICE AND EACH SUBSEQUENT STATEMENT CONTAINS INFORMATION CONCERNING FINANCIAL ASSISTANCE AS WELL AS CONTACT INFORMATION FOR QUESTIONS. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION ---------------------- THE MEDICAL CENTER AT ALBANY SERVES THE NEEDS OF PATIENTS AND PHYSICIANS OF CLINTON COUNTY, KY AND SURROUNDING COUNTIES. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH ---------------------------------- AS PART OF COMMONWEALTH HEALTH CORPORATION, THE MEDICAL CENTER AT ALBANY IS PATIENT-FOCUSED, QUALITY-DRIVEN AND MISSION-LED. OUR MISSION IS TO CARE FOR PEOPLE AND IMPROVE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. WE COMBINE STATE-OF-THE-ART TECHNOLOGY, UNSURPASSED PERSONAL CARE, AND THE FINEST HEALTHCARE PROFESSIONALS TO ENSURE EACH VISIT IS THE VERY BEST IT CAN BE. MCA OFFERS FREE STROKE SCREENINGS AT COMMUNITY EVENTS, WORKSITES AND HEALTH FAIRS AND PROVIDES EARLY HEART ATTACK CARE (EHAC) EDUCATION AT LOCAL HEALTH FAIRS. MCA INCREASES COMMUNITY AWARENESS AND KNOWLEDGE OF THE OPIOID EPIDEMIC THROUGH "THE CHOICE IS YOURS" ENRICHMENT EVENT HELD FOR HIGH SCHOOL JUNIORS AND SENIORS. MCA INCREASES COMMUNITY AWARENESS AND KNOWLEDGE REGARDING THE RISKS OF OBESITY BY SPONSORING LOCAL 5KS, PROVIDING WEIGHT LOSS INFORMATION AT LOCAL FESTIVALS AND HOLDING WEIGHT LOSS SEMINARS. MCA PROVIDES CANCER PREVENTION INFORMATION AT LOCAL FESTIVALS AND FAIRS, DISTRIBUTING EDUCATIONAL MATERIALS AND PROMOTIONAL ITEMS PROMOTING AWARENESS AND PREVENTATIVE SCREENINGS. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM ------------------------------ THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY (MCA) IS OWNED AND CONTROLLED BY COMMONWEALTH HEALTH CORPORATION, A RELATED 501(C)(3) ORGANIZATION. COMMONWEALTH HEALTH CORPORATION (CHC) IS A HOLDING COMPANY FOR A TOTAL OF TWELVE FOR-PROFIT AND NONPROFIT CORPORATIONS AND PARTNERSHIPS (COLLECTIVELY, THE "AFFILIATES") ENGAGED IN VARIOUS ASPECTS OF THE HEALTH CARE INDUSTRY. CHC OWNS AND OPERATES MULTIPLE PHYSICIAN PRACTICES, WHICH ARE ACQUIRED TO ATTRACT AND RETAIN HIGHLY SKILLED PHYSICIANS IN SPECIALTIES THAT SUPPORT THE MISSION OF CHC AND ITS AFFILIATES. IN ADDITION, CHC OPERATES AND PROVIDES VARIOUS CORPORATE SUPPORT SERVICES INCLUDING PATIENT BILLING, COLLECTIONS, ACCOUNTING, MATERIALS MANAGEMENT, ENGINEERING, SECURITY, HUMAN RESOURCES, INFORMATION SYSTEMS, AND ADMINISTRATIVE SUPPORT TO ITS AFFILIATES. CHC HAS ESTABLISHED VARIOUS DIVISIONS FOR ITS OPERATIONS, INCLUDING THE NONPROFIT ORGANIZATIONS DESCRIBED BELOW (IN ADDITION TO THE MEDICAL CENTER AT ALBANY) AND OTHER NONPROFIT AND FOR-PROFIT CORPORATIONS AND PARTNERSHIPS. BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION ("THE MEDICAL CENTER"): ----------------- BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION ("THE MEDICAL CENTER") IS A NONPROFIT KENTUCKY CORPORATION THAT OPERATES A 337-BED HOSPITAL FACILITY IN BOWLING GREEN, KENTUCKY UNDER THE NAME "THE MEDICAL CENTER AT BOWLING GREENSINCE OCTOBER 1996, A 25-BED CRITICAL ACCESS HOSPITAL AND 110-BED NURSING HOME FACILITY IN SCOTTSVILLE, KENTUCKY, UNDER THE NAME "THE MEDICAL CENTER AT SCOTTSVILLE." IN ADDITION, SINCE JANUARY 2016, THE CORPORATION HAS OPERATED A 25-BED CRITICAL ACCESS ACUTE CARE HOSPITAL IN HORSE CAVE, KENTUCKY UNDER THE NAME "THE MEDICAL CENTER AT CAVERNA." THE THREE FACILITIES ARE PART OF ONE CORPORATION BUT ARE SEPARATELY LICENSED BY THE STATE OF KENTUCKY. THE MEDICAL CENTER IS THE SOLE MEMBER OF MEDICAL CENTER EMS, LLC (EMS), MEDICAL CENTER PHARMACY OF BOWLING GREEN, LLC (RIVERSIDE PHARMACY) AND ENSPIRE QUALITY PARTNERS, LLC (MED CENTER HEALTH PARTNERS). EMS PROVIDES AMBULANCE SERVICES IN WARREN COUNTY, KENTUCKY. RIVERSIDE OFFERS RETAIL PHARMACY SERVICES IN BOWLING GREEN, KY. MED CENTER HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF HEALTHCARE PROVIDERS, WORKING TOGETHER UNDER A PHYSICIAN-LED STRUCTURE TO IMPROVE POPULATION HEALTH, IMPROVE PATIENT EXPERIENCE AND REDUCE THE COST OF HEALTHCARE. THE CORPORATION IS BOTH THE LIMITED PARTNER AND A GENERAL PARTNER IN THE MEDICAL PLAZA PARTNERS, LLP WHICH PROVIDES ON-CAMPUS SPACE FOR HOSPITAL DEPARTMENTS AND OTHER NON-AFFILIATE MEDICAL-RELATED SERVICES. TOGETHER WITH ANOTHER AREA NON-PROFIT ACUTE CARE HOSPITAL CORPORATION, TMC IS AN EQUAL OWNER OF THE BARREN RIVER REGIONAL CANCER CENTER, INC., AN OUTPATIENT RADIATION THERAPY CARE SERVICE LOCATED IN GLASGOW, KENTUCKY. THE MEDICAL CENTER AT SCOTTSVILLE OPERATES TWO RURAL HEALTH CLINICS, ONE IN SCOTTSVILLE, KY AND ONE IN FOUNTAIN RUN, KY. THE MEDICAL CENTER AT CAVERNA OPERATES TWO RURAL HEALTH CLINICS, ONE IN MUNFORDVILLE, KY AND ONE IN HORSE CAVE, KY. COMMONWEALTH HEALTH FREE CLINIC, INC.: -------------------- COMMONWEALTH HEALTH FREE CLINIC, INC. ("CHFC") WAS ORGANIZED TO OPERATE A CLINIC, WHICH PROVIDES BASIC MEDICAL AND DENTAL DIAGNOSTIC AND TREATMENT SERVICES FOR CHARITABLE PURPOSES FOR THE UNINSURED AND UNDERINSURED OF SOUTH-CENTRAL KENTUCKY AND ALSO SERVES INDIVIDUALS WHO MAY BE COVERED BY SOME FORM OF INSURANCE, BUT WHO ARE UNABLE TO ACCESS A PROVIDER FOR ACUTE OR CHRONIC HEALTHCARE ISSUES. THE CLINIC OFFERS SERVICES INCLUDING NON-EMERGENCY CLINICAL SERVICES, DENTISTRY, COMMUNITY HEALTH EDUCATION AND COUNSELING, DISEASE/CONDITION SPECIFIC EDUCATION AND COUNSELING, AND ACCESS TO PHARMACEUTICALS. COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC: --------------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC IS A LONG-TERM ACUTE CARE HOSPITAL THAT OPERATES AS A HOSPITAL WITHIN A HOSPITAL BY LEASING BEDS FROM THE MEDICAL CENTER ON ITS BOWLING GREEN CAMPUS. IT IS AN ACUTE CARE HOSPITAL FOR THOSE PATIENTS REQUIRING AN EXTENDED HOSPITAL STAY (ANTICIPATED LENGTH OF STAY BETWEEN 18-35 DAYS) AND GENERALLY HAVING COMPLEX OR CHRONIC MEDICAL CONDITIONS. THE MEDICAL CENTER AT FRANKLIN, INC.: --------------------- THE MEDICAL CENTER AT FRANKLIN, INC. (MCF) OPERATES A HOSPITAL IN THE COMMUNITY OF FRANKLIN, SIMPSON COUNTY, KENTUCKY. THIS LOCATION IS JUST 20 MILES FROM THE MEDICAL CENTER'S BOWLING GREEN CAMPUS. MCF IS A MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL OFFERING ACUTE CARE INPATIENT AND OUTPATIENT PROGRAMS IN ITS 25 BED ACUTE CARE FACILITY. THE MEDICAL CENTER AT FRANKLIN, INC. OPERATES A RURAL HEALTH CLINIC IN FRANKLIN, KY. COMMONWEALTH HEALTH FOUNDATION: ------------------------ CHC ENDORSED THE ESTABLISHMENT OF COMMONWEALTH HEALTH FOUNDATION ("THE FOUNDATION") FOR THE PURPOSE OF FOSTERING, SUPPORTING AND INITIATING ACTIVITIES FOR THE AFFILIATED NON-PROFIT 501(C)(3) ORGANIZATIONS. THE FOUNDATION BUILDS RELATIONSHIPS THAT INSPIRE CHARITABLE GIVING IN SUPPORT OF CHC'S MISSION TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. BLUEGRASS OUTPATIENT CENTER: --------------------------- SINCE 2008, CHC HAS BEEN THE SOLE OWNER OF BLUEGRASS OUTPATIENT CENTER OF BOWLING GREEN, LLC ("BLUEGRASS"). BLUEGRASS PROVIDES COMPREHENSIVE OUTPATIENT REHABILITATION THERAPY SERVICES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MS LAURA BELCHER | ||||||||||||||
| VICE PRESIDENT/ADMINISTRATOR | $157,334 | $0 | $0 | $0 | $3,733 | $0 | $5,056 | $0 | $35,204 | $0 | $201,327 | $0 | $0 | $0 |
| MR DAVID GRAY | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $0 | $376,518 | $0 | $0 | $0 | $8,634 | $0 | $9,150 | $0 | $34,849 | $0 | $429,151 | $0 | $0 |
| MR ERIC HAGAN | ||||||||||||||
| VP OF RURAL HOSPITALS | $28,911 | $260,201 | $0 | $0 | $694 | $6,246 | $0 | $0 | $1,996 | $17,962 | $31,601 | $284,409 | $0 | $0 |
| MS MICHELE W LAWLESS | ||||||||||||||
| EXECUTIVE VICE PRESIDENT/CFO | $0 | $415,047 | $0 | $0 | $0 | $6,702 | $0 | $0 | $0 | $3,491 | $0 | $425,240 | $0 | $0 |
| MS CONNIE D SMITH | ||||||||||||||
| PRESIDENT / CEO | $0 | $992,844 | $0 | $0 | $0 | $293,149 | $0 | $0 | $0 | $20,191 | $0 | $1,306,184 | $0 | $0 |
| MR WADE STONE | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $0 | $471,203 | $0 | $0 | $0 | $29,929 | $0 | $0 | $0 | $20,005 | $0 | $521,137 | $0 | $0 |
| MS KATRINA WOOD | ||||||||||||||
| VP/CHIEF NURSING OFFICER | $0 | $216,316 | $0 | $0 | $0 | $3,062 | $0 | $5,519 | $0 | $29,821 | $0 | $254,718 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3: | ---------------------------- THE CEO IS COMPENSATED BY COMMONWEALTH HEALTH CORPORATION (CHC), A RELATED ORGANIZATION. CHC USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| SCHEDULE J, PART I, LINE 4B: | ------------------------------- CERTAIN EXECUTIVES OF COMMONWEALTH HEALTH CORPORATION PARTICIPATED IN A SUPPLEMENTAL RETIREMENT PLAN. THE CURRENT YEAR INCREASE IN THE ACCRUED BENEFIT, AS ACTUARIALLY DETERMINED, IS REPORTED AS COMPENSATION. THE FOLLOWING ARE THE INDIVIDUALS PARTICIPATING IN THE PLAN AND THE CURRENT YEAR INCREASES REPORTED AS COMPENSATION: CONNIE SMITH $274,682 WADE STONE $ 27,694 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A & 4B | PROGRAM SERVICE NARRATIVE -------------------------- DURING 2016, COMMONWEALTH HEALTH CORPORATION (CHC) ASSUMED MANAGEMENT OF CLINTON COUNTY HOSPITAL. CLINTON COUNTY HOSPITAL JOINED CHC AND BECAME THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY. THE HOSPITAL'S PROFESSIONAL STAFF INCLUDES PHYSICIANS WHO ARE ENGAGED IN THE PRACTICE OF MEDICINE AND WHO REPRESENT MULTIPLE SPECIALTIES, INCLUDING FAMILY PRACTICE AND EMERGENCY CARE. THE STAFF ALSO INCLUDES NURSES, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPISTS, PSYCHOLOGISTS, RESPIRATORY THERAPISTS, NUTRITIONISTS AND OTHERS. USING AN INTERDISCIPLINARY TEAM APPROACH, THE STAFF WORKS COLLABORATIVELY TO PROVIDE PRIMARY OUTPATIENT CARE, RENDERED IN AN EMERGENCY ROOM AND OUTPATIENT SETTING, AND SECONDARY CARE CONSISTING OF INPATIENT SERVICES OF A GENERAL AND SPECIALIZED NATURE. SERVICES INCLUDE: - Cardiology - Cardiopulmonary Rehabilitation - Computed Tomography (CT) - Diagnostic Imaging - Digital Mammography - Emergency Department - Infectious Disease - Laboratory Services - Magnetic Resonance Imaging (MRI) - Nuclear Medicine - Oncology - Orthopaedics - Physical Rehabilitation - Respiratory Care - Telehealth DURING THE FISCAL YEAR 2023 THE HOSPITAL PROVIDED THE FOLLOWING DAYS OF CARE: 1,563 ACUTE PATIENT DAYS, 57 HOSPICE DAYS, 1,032 SWING BED PATIENT DAYS, AND 1,125 OBSERVATION DAYS. |
| FORM 990, PART V, LINE 2A | MANAGEMENT SERVICES AGREEMENT --------------------------------- COMMONWEALTH HEALTH CORPORATION HAS A MANAGEMENT SERVICES AGREEMENT FOR THE FOLLOWING RELATED ORGANIZATIONS: BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION, THE MEDICAL CENTER AT FRANKLIN, INC., THE MEDICAL CENTER AT CLINTON COUNTY, INC., AND COMMONWEALTH REGIONAL SPECIALTY HOSPITAL. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 31-1118087. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS ----------- THE CORPORATION'S ARTICLES OF INCORPORATION SPECIFY THE CORPORATION SHALL HAVE ONE (1) MEMBER. THE MEMBER SHALL BE COMMONWEALTH HEALTH CORPORATION, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A & 7B | POWER OF MEMBERS ------------------- LINE 7A: BYLAWS OF THE CORPORATION SPECIFY THAT THE SOLE MEMBER SHALL APPOINT A NOMINATING COMMITTEE WHICH SHALL MEET AND DESIGNATE NOMINEES FOR BOARD DIRECTORSHIPS. LINE 7B: THE BYLAWS MAY BE REVISED OR AMENDED BY AFFIRMATIVE VOTE OF TWO-THIRDS(2/3) OF THE BOARD, SUBJECT TO APPROVAL OF THE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW FORM 990 ---------------------------- FORM 990 IS PLACED ELECTRONICALLY ON A COMPANY WEBSITE USED TO SHARE INFORMATION WITH BOARD MEMBERS. EACH BOARD MEMBER IS PROVIDED ACCESS TO THE WEBSITE AND IS ASKED TO REVIEW FORM 990 PRIOR TO A DESIGNATED DATE ON WHICH THE RETURN WILL BE FILED. ADVANCE NOTICE IS GIVEN TO BOARD MEMBERS SO THEY MAY REVIEW THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------------ THE COMMONWEALTH HEALTH CORPORATION (CHC) (APPLICABLE TO THE CORPORATION AND/OR ITS AFFILIATES) CODE OF CONDUCT EXPLICITLY STATES MEMBERS OF THE BOARD, ADMINISTRATION, THE MEDICAL STAFF AND ALL EMPLOYEES ARE EXPECTED TO AVOID CONFLICTS OF INTEREST. FURTHER, IT REQUIRES DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST IN A TIMELY MANNER. ALL INDIVIDUALS SIGN AN ACKNOWLEDGEMENT UPON EMPLOYMENT THAT THEY HAVE RECEIVED A COPY OF THE CODE OF CONDUCT, ARE FAMILIAR WITH ITS CONTENT AND UNDERSTAND THEIR RESPONSIBILITIES TO AVOID NON-COMPLIANT ACTIVITY. CHC'S REGULATORY COMPLIANCE AND COMPENSATION COMMITTEE (RCC) REVIEWS AND APPROVES ALL CONTRACTS BETWEEN CHC AND/OR ITS AFFILIATES AND DISQUALIFIED ENTITIES. THE REVIEW IS DESIGNED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST BY BOARD MEMBERS AND/OR OFFICERS. RCC MEMBERS ARE PROHIBITED FROM TAKING PART IN DECISIONS REGARDING TRANSACTIONS WITH WHICH HE/SHE HAS A CONFLICT OF INTEREST. ANNUALLY, WRITTEN INQUIRY IS MADE - BY QUESTIONNAIRE - OF BOARD MEMBERS AND OFFICERS SEEKING DISCLOSURE OF CONFLICTS OF INTEREST OR INFORMATION THAT RELATES TO FAMILY MEMBERS. TRANSACTIONS ARISING ARE REVIEWED BY MANAGEMENT AS THEY OCCUR. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | DETERMINING COMPENSATION --------------------------- MEDICAL CENTER AT CLINTON COUNTY IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS COMMONWEALTH HEALTH CORPORATION, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEEN AND COORDINATED THROUGH COMMONWEALTH HEALTH CORPORATION, INC. CHC USES INDEPENDENT CONSULTANTS TO ANNUALLY REVIEW COMPENSATION. COMPENSATION-RELATED DETERMINATIONS ARE CONDUCTED IN ACCORDANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE AND REGULATIONS TO QUALIFY FOR THE PRESUMPTION THAT THE COMPENSATION IS REASONABLE, INCLUDING BUT NOT LIMITED TO APPROVAL BY AN AUTHORIZED COMMITTEE OF THE BOARD OF DIRECTORS WHO DO NOT HAVE A CONFLICT OF INTEREST, OBTAINING AND RELYING ON APPROPRIATE DATA AS TO COMPARABILITY, AND CONCURRENT DOCUMENTATION OF THE BASIS FOR THE COMPENSATION DETERMINATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | MAKING DOCUMENTS AVAILABLE TO THE PUBLIC ------------------------------------------ GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ONLY MADE AVAILABLE IF REQUESTED, AND IN THE MANNER REQUIRED, BY A GOVERNING AGENCY. |
| FORM 990, PART XII, LINE 2C | OVERSIGHT PROCESS --------------------- THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION AGENCY FEES TOTAL FEES:112875 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL CONSULTING FEES TOTAL FEES:970739 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:712616 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB FEES TOTAL FEES:8725 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT FEES TOTAL FEES:357812 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING FEES TOTAL FEES:222435 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:EMPLOYEE SUPPORT FEES TOTAL FEES:16458 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:AGENCY NURSING FEES TOTAL FEES:174223 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BOWLING GREEN-WARREN CTY COMM HOSP CORP | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 610920842 | HOSPITAL | KY | 501(C)(3) | 3 | CHC INC | false |
| THE MEDICAL CENTER AT FRANKLIN | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 611362001 | HOSPITAL | KY | 501(C)(3) | 3 | CHC INC | false |
| COMMONWEALTH REGIONAL SPECIALTY HOSPITAL | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 542142034 | HOSPITAL | KY | 501(C)(3) | 3 | CHC INC | false |
| COMMONWEALTH HEALTH FREE CLINIC | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 611292739 | HEALTHCARE | KY | 501(C)(3) | 3 | CHC INC | false |
| COMMONWEALTH HEALTH FOUNDATION INC | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 611362000 | SUPPORT | KY | 501(C)(3) | 7 | CHC INC | false |
| COMMONWEALTH HEALTH CORPORATION | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 311118087 | SUPPORT | KY | 501(C)(3) | 10 | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDICAL PLAZA PARTNERS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 PARK STREET | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611080340 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |