UOFL HEALTH-SHELBYVILLE INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- UOFL HEALTH-SHELBYVILLE INC (EIN 84-3196350)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-14
- IRS object ID
- 202401359349302680
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-14T09:56:30-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 EASTPOINT PKWY SUITE 300 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 843196350 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | U OF L HEALTH - SHELBYVILLE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UOFL | BusinessNameControlTxt |
| Phone | 5025617213 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 S JACKSON STREET | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIRK STRACK CFO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5025623621 | PhoneNum |
| Signature | 2024-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KIRK | PersonFirstNm |
| Person Last | STRACK CFO | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMILIE M KNIERIEM CPA | PreparerPersonNm |
| PTIN | P01330194 | PTIN |
| Phone | 5029923500 | PhoneNum |
| Preparation | 2024-05-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KIRK STRACK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 S JACKSON STREET | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,925,141 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.UOFLHEALTHNETWORK.ORG/SHELBYVILLE-HOS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2019 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE AND MAINTAIN A HOSPITAL AFFILIATED WITH THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE AND TO PROVIDE CARE FOR THE PEOPLE WHO ARE IN NEED OF THOSE, OR RELATED, MEDICAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,092,516 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,164,093 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $31,980,105 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,548,830 | CYProgramServiceRevenueAmt |
| PY Investment Income | $18,137 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $145,080 | PYOtherRevenueAmt |
| CY Other Revenue | $212,218 | CYOtherRevenueAmt |
| PY Total Revenue | $33,235,838 | PYTotalRevenueAmt |
| CY Total Revenue | $35,925,141 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $13,320 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $18,123 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,496,169 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,181,243 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,536,337 | PYOtherExpensesAmt |
| CY Other Expenses | $20,780,559 | CYOtherExpensesAmt |
| PY Total Expenses | $35,045,826 | PYTotalExpensesAmt |
| CY Total Expenses | $37,979,925 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,809,988 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,054,784 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,961,052 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,415,943 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,124,711 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,845,171 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,836,341 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,570,772 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO OPERATE AND MAINTAIN A HOSPITAL AFFILIATED WITH THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE AND TO PROVIDE CARE FOR THE PEOPLE WHO ARE IN NEED OF THOSE, OR RELATED, MEDICAL SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,551,548 | ExpenseAmt |
| Grant | $18,123 | GrantAmt |
| Revenue | $33,695,537 | RevenueAmt |
| Desc | UOFL HEALTH SHELBYVILLE, INC. OWNS AND OPERATES A 70-BED HOSPITAL LOCATED AT 727 HOSPITAL DRIVE IN SHELBYVILLE, KENTUCKY. FOR MORE THAN A CENTURY, SHELBYVILLE HOSPITAL HAS SERVED THE PEOPLE OF SHELBY AND SURROUNDING COUNTIES WITH HIGH-QUALITY HEALTH CARE. THE HOSPITAL SERVES RESIDENTS OF SHELBY, HENRY, AND SPENCER COUNTIES. THE HOSPITAL OFFERS A FULL COMPLEMENT OF INPATIENT AND OUTPATIENT CARE, INCLUDING: 24/7 EMERGENCY CARE, INTENSIVE CARE UNIT, INPATIENT CARE (MEDICAL/SURGICAL), DIAGNOSTIC IMAGING: MRI, CT, PET/CT, NUCLEAR CARDIOLOGY, ULTRASOUND, 3D MAMMOGRAPHY, BONE DENSITY, GENERAL AND SPECIALIZED SURGERY: ENDOSCOPY, ENT GASTROENTEROLOGY, ORTHOPEDICS, PODIATRY, UROLOGY, VASCULAR SURGERY, PAIN MANAGEMENT, CARDIOLOGY, CARDIAC REHAB/HEALTHY LIFESTYLE CENTER, SLEEP MEDICINE, FRAZIER REHAB INSTITUTE - PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, DIABETES AND NUTRITION COUNSELING, OUTPATIENT INFUSION SERVICES, CLINICAL LABORATORY AND PHARMACY. | Desc |
| Total Program Service Expenses | $31,551,548 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5025617213 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 S JACKSON STREET | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| THOMAS D MILLER | ||||||||
| PRESIDENT/CEO UOFL HEALTH | 2.00 | 44.00 | Yes (X) | Yes (X) | $0 | $1,623,505 | $30,314 | |
| VALERIE BRIONES-PRYOR MD | ||||||||
| CHAIR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $479,193 | $44,104 | |
| ANDREW DUFFEE MD | ||||||||
| VICE CHAIR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $858,067 | $55,186 | |
| RON CAUGHRON | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KENNETH GARDNER MD | ||||||||
| MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $186,291 | $24,291 | ||
| PAT HARGADON | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RAY LEATHERS | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTOPHER THEUER MD | ||||||||
| MEMBER (TERM END 11/22) | 1.00 | 40.00 | Yes (X) | $0 | $551,481 | $42,655 | ||
| RON WALDRIDGE II MD | ||||||||
| MEMBER (TERM END) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY WALLS | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JANICE HARRIS | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVE MEADOR | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GREG PFISTER MD | ||||||||
| MEMBER (TERM BEG) | 1.00 | 40.00 | Yes (X) | $0 | $419,203 | $18,034 | ||
| TROY RAWLINS | ||||||||
| MEMBER (TERM BEG) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL DOUZUK JR | ||||||||
| CFO UOFL HEALTH (END 2023) | 2.00 | 44.00 | Yes (X) | $0 | $950,873 | $33,334 | ||
| KEN MARSHALL | ||||||||
| COO UOFL HEALTH | 2.00 | 44.00 | Yes (X) | $0 | $950,038 | $13,497 | ||
| TIMOTHY AARON GAROFOLA | ||||||||
| CEO SHELBYVILLE HOSPITAL | 40.00 | Yes (X) | $0 | $447,682 | $35,951 | |||
| ANNESSA BAKER | ||||||||
| COO/CNO | 40.00 | Yes (X) | $0 | $202,315 | $14,011 | |||
| KIRK STRACK | ||||||||
| CFO UOFL HEALTH | 2.00 | 44.00 | Yes (X) | $0 | $508,411 | $29,809 | ||
| MICHELLE H LEDGER | ||||||||
| DIRECTOR - LABRATORY | 40.00 | $0 | $113,788 | $22,266 | Yes (X) | |||
| AMY CAPPS | ||||||||
| DIRECTOR - NURSING | 40.00 | $0 | $113,541 | $29,227 | Yes (X) | |||
| JAMES BOSE | ||||||||
| DIRECTOR - IMAGING SERVICE | 40.00 | $0 | $134,520 | $25,835 | Yes (X) | |||
| KELLY NOLAN | ||||||||
| DIRECTOR - NURSING | 40.00 | $0 | $133,005 | $10,979 | Yes (X) | |||
| EMILY MIRACLE | ||||||||
| SUPERVISOR - PT SERVICES | 40.00 | $0 | $105,509 | $8,560 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,777,422 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $438,053 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| METZ CULINARY MANAGEMENT | |||||
| TWO WOODLANDS DRIVE | DALLAS | PA | 18612 | FOOD/ENVIRONMENTAL SERVICES | $1,036,323 |
| ALLIED UNIVERSAL SECURITY SERVICES | |||||
| PO BOX 277469 | ATLANTA | GA | 30384 | SECURITY SERVICES | $283,628 |
| MEDICAL CENTER LAUNDRY | |||||
| 1400 STORY AVENUE | LOUISVILLE | KY | 40206 | LAUNDRY SERVICES | $155,813 |
| VASCULAR ACCESS INC | |||||
| PO BOX 444 | GEORGETOWN | IN | 47122 | PROFESSIONAL SERVICES | $155,245 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| 1900 S STATE COLLEGE BLVD | ANAHEIM | CA | 92806 | PET/CT SERVICES | $114,257 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,164,093 | GovernmentGrantsAmt |
| Total Contributions | $2,164,093 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621999 | BusinessCd |
| Total Revenue Column | $33,548,830 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,548,830 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,548,830 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $59,144 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $59,144 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,144 | TotalRevenueColumnAmt |
| Exclusion | $59,144 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $3,495 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,495 | TotalRevenueColumnAmt |
| Exclusion | $3,495 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CONTRACTED SERVICES | 900099 | $3,360 | $3,360 | |
| EARNINGS IN KMRRRG | 900099 | $2,872 | $2,872 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $143,347 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $143,347 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $149,579 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,925,141 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,695,537 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $65,511 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,123 | TotalAmt |
| Program Services | $18,123 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,857,726 | TotalAmt |
| Program Services | $11,743,011 | ProgramServicesAmt |
| Management And General | $2,114,715 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,219 | TotalAmt |
| Program Services | $925 | ProgramServicesAmt |
| Management And General | $294 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,352,027 | TotalAmt |
| Program Services | $1,784,394 | ProgramServicesAmt |
| Management And General | $567,633 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $970,271 | TotalAmt |
| Program Services | $736,108 | ProgramServicesAmt |
| Management And General | $234,163 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,016 | TotalAmt |
| Program Services | $36,669 | ProgramServicesAmt |
| Management And General | $32,347 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,266,811 | TotalAmt |
| Program Services | $4,604,209 | ProgramServicesAmt |
| Management And General | $1,662,602 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,231 | TotalAmt |
| Program Services | $3,051 | ProgramServicesAmt |
| Management And General | $5,180 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $474,951 | TotalAmt |
| Program Services | $470,981 | ProgramServicesAmt |
| Management And General | $3,970 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555,488 | TotalAmt |
| Program Services | $196,592 | ProgramServicesAmt |
| Management And General | $358,896 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,445 | TotalAmt |
| Program Services | $2,760 | ProgramServicesAmt |
| Management And General | $4,685 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $885 | TotalAmt |
| Program Services | $328 | ProgramServicesAmt |
| Management And General | $557 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,340,773 | TotalAmt |
| Program Services | $751,622 | ProgramServicesAmt |
| Management And General | $589,151 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,849 | TotalAmt |
| Program Services | $117,088 | ProgramServicesAmt |
| Management And General | $198,761 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $5,212,261 | $5,212,261 | |
| CORPORATE ALLOCATION EX | $3,400,116 | $3,400,116 | |
| PROVIDER TAX | $1,587,344 | $1,587,344 | |
| REPAIRS & MAINTENANCE | $1,428,069 | $843,957 | $584,112 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,320 | TotalAmt |
| Program Services | $42,009 | ProgramServicesAmt |
| Management And General | $71,311 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,979,925 | TotalAmt |
| Program Services | $31,551,548 | ProgramServicesAmt |
| Management And General | $6,428,377 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,591,871 | BOYAmt |
| EOY | $5,592,052 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $704,547 | BOYAmt |
| EOY | $779,900 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,812 | BOYAmt |
| EOY | $22,575 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,177,146 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,409,912 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,249,893 | BOYAmt |
| EOY | $7,767,234 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $364,929 | BOYAmt |
| EOY | $1,254,182 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,961,052 | BOYAmt |
| EOY | $15,415,943 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,365,728 | BOYAmt |
| EOY | $3,117,081 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,377,695 | BOYAmt |
| EOY | $2,505,908 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,381,288 | BOYAmt |
| EOY | $1,222,182 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,124,711 | BOYAmt |
| EOY | $6,845,171 | 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 | $5,836,341 | BOYAmt |
| EOY | $8,570,772 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,836,341 | BOYAmt |
| EOY | $8,570,772 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,961,052 | BOYAmt |
| EOY | $15,415,943 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,054,784 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,789,215 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,940 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,940 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: KENTUCKY HOSPITAL ASSOCIATION - $1,034.62 AND AMERICAN HOSPITAL ASSOCIATION - $905. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,000,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,000,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,237,144 | OtherCostOrOtherBasisAmt |
| Depreciation | $828,239 | DepreciationAmt |
| Book Value | $1,408,905 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $208,537 | OtherCostOrOtherBasisAmt |
| Depreciation | $74,112 | DepreciationAmt |
| Book Value | $134,425 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,640,641 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,507,561 | DepreciationAmt |
| Book Value | $5,133,080 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $90,824 | OtherCostOrOtherBasisAmt |
| Book Value | $90,824 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,767,234 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HRIP RECEIVABLE | Desc |
| Book Value | $1,254,182 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,254,182 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY SETTLEMENTS | $654,008 |
| RELATED PARTY PAYABLE | $568,174 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,222,182 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF AN UNCERTAIN POSITION HAS BEEN TAKEN THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION HAS FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR THE PERIODS THROUGH JUNE 30, 2022 AND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,564,641 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $588,684 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $975,957 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02570 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,604,837 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,925,951 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,678,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12320 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,169,478 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,514,635 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,654,843 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14890 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 217 | PersonsServedCnt |
| Total Community Benefit Expns | $47,679 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,679 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4 | PersonsServedCnt |
| Total Community Benefit Expns | $87,342 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $87,342 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,268 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,268 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 221 | PersonsServedCnt |
| Total Community Benefit Expns | $148,289 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $148,289 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 221 | PersonsServedCnt |
| Total Community Benefit Expns | $10,317,767 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,514,635 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,803,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15280 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,025 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,025 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,878 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,936 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $35,936 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,232,572 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,933,536 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,382,997 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,449,461 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | U OF L HEALTH - SHELBYVILLE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 727 HOSPITAL DRIVE | AddressLine1Txt |
| City | SHELBYVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40065 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 100385 | 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 | U OF L HEALTH - SHELBYVILLE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://UOFLHEALTH.ORG/COMMUNITY-NEEDS-ASSESSMENT/2020-2022-REPORTS/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://UOFLHEALTH.ORG/COMMUNITY-NEEDS-ASSESSMENT/2020-2022-REPORTS/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://UOFLHEALTH.ORG/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://UOFLHEALTH.ORG/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://UOFLHEALTH.ORG/FINANCIAL-ASSISTANCE/ | 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 (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| U OF L HEALTH - SHELBYVILLE INC. | PART V, SECTION B, LINE 5: UOFL HEALTH CONTRACTED WITH BLUE AND CO., LLC TO CONDUCT THE MOST RECENT CHNA IN THE SPRING OF 2022. DURING DATA COLLECTION, BLUE AND CO. INTERVIEWED MEMBERS OF THE COMMUNITY FROM ACROSS THE HOSPITAL'S SERVICE AREA. THESE INCLUDED REPRESENTATIVES FROM GOVERNMENT, PUBLIC HEALTH, MEDICAL PROVIDERS, NONPROFIT LEADERS, FAITH-BASED INSTITUTIONS, ELECTED OFFICIALS, AND LAW ENFORCEMENT. ONLINE SURVEYS WERE ALSO DISTRIBUTED THROUGHOUT THE SERVICE AREA, MANY THROUGH THE COMMUNICATION CHANNELS OF THESE REPRESENTATIVES. DATA FROM THE INTERVIEWS AND SURVEYS INFORMED THE RESULTS AND ASSISTED THE HOSPITAL IN IDENTIFYING PRIORITY AREAS. MEMBERS FROM THESE COMMUNITY GROUPS ALSO PARTICIPATED IN AN ADVISORY GROUP TO DETERMINE IMPLEMENTATION STRATEGIES FOR EACH OF THE PRIORITY NEEDS IDENTIFIED. FOR FEEDBACK ON PREVIOUS CHNAS, AN ONLINE FEEDBACK FORM WAS MADE AVAILABLE ON THE UOFL HEALTH WEBSITE AT <HTTPS://UOFLHEALTH.ORG/ABOUT/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-FEEDBACK/>. ANY COMMENTS COLLECTED THROUGH THE FORM WERE INCLUDED IN THE CHNA PROCESS. |
| U OF L HEALTH - SHELBYVILLE INC. | PART V, SECTION B, LINE 6A: UOFL HEALTH, AS A HEALTH CARE SYSTEM, CONTRACTED WITH BLUE AND CO., LLC TO CONDUCT THE MOST RECENT CHNA IN THE SPRING OF 2022. THE OTHER FIVE HOSPITALS INCLUDED IN THE SYSTEM FELL INTO THE SAME CHNA TIMELINE AS SHELBYVILLE. THEREFORE, BLUE AND CO. COLLECTED PRIMARY AND SECONDARY FOR ALL HOSPITALS AT THE SAME TIME. THE SAME SURVEY TOOL WAS USED FOR ALL HOSPITALS. THESE INCLUDED: JEWISH HOSPITAL, PEACE HOSPITAL, MARY AND ELIZABETH HOSPITAL, UOFL HOSPITAL, SHELBYVILLE HOSPITAL, AND FRAZIER REHABILITATION INSTITUTE. |
| U OF L HEALTH - SHELBYVILLE INC. | PART V, SECTION B, LINE 7D: HTTPS://UOFLHEALTH.ORG/COMMUNITY-NEEDS-ASSESSMENT/2020-2022-REPORTS/ |
| U OF L HEALTH - SHELBYVILLE INC. | PART V, SECTION B, LINE 11: THE CHNA IDENTIFIED THE FOLLOWING OVERALL NEEDS FOR SHELBYVILLE HOSPITAL: ACCESS TO HEALTH CARE, MENTAL HEALTH, SMOKING CESSATION, HEALTH EQUITY AND DISPARITIES, AND OBESITY/INACTIVITY. HOSPITAL LEADERSHIP DETERMINED NOT TO ADDRESS OBESITY/INACTIVITY AS A PRIORITY SINCE IT WAS NOT AN AREA WHERE THE HOSPITAL HAD SERVICE LINES IN PLACE TO ADDRESS IT, NOR COULD THEY MAKE A SIGNIFICANT IMPACT WITH AVAILABLE RESOURCES. HEALTH EQUITY AND DISPARITIES WILL BE ADDRESSED AS A SYSTEM-WIDE PRIORITY. EACH PRIORITY HAS A GOAL STATEMENT, CATEGORIES OF ACTION, AND SPECIFIC STRATEGIES. ACCESS TO HEALTH CARE WILL BE ADDRESSED THROUGH THE FOLLOWING GOALS AND CATEGORIES OF STRATEGY:- GOAL: INCREASE ACCESS TO HIGH QUALITY, EQUITABLE HEALTH CARE AND COMMUNITY RESOURCES FOR UNDERSERVED INDIVIDUALS AND COMMUNITIESSTRATEGIES:- INCREASE PHYSICIANS, FACILITIES, AND SERVICES- BUILD SUSTAINABLE, MUTUALLY BENEFICIAL PARTNERSHIPS- CONNECT PATIENTS TO RESOURCESMENTAL HEALTH WILL BE ADDRESSED THROUGH THE FOLLOWING GOALS AND CATEGORIES OF STRATEGY:- GOAL: INCREASE PROGRAMMING AND SERVICES THAT FOCUS ON THE TREATMENT & SAFETY OF INDIVIDUALS LIVING WITH MENTAL ILLNESS AND SUBSTANCE USE DISORDERSTRATEGIES:- ENHANCE BEHAVIORAL HEALTH SERVICES- ENSURE THE SAFETY OF PATIENTS LIVING WITH SUBSTANCE USE DISORDERSMOKING WILL BE ADDRESSED THROUGH THE FOLLOWING GOALS AND CATEGORIES OF STRATEGY:- GOAL: INCREASE THE CONNECTION TO SERVICES AND RESOURCES FOR SMOKING, VAPING, AND E-CIGARETTE CESSATION AND PREVENTIONSTRATEGIES:- UTILIZE EXISTING RESOURCES- BUILD SUSTAINABLE, MUTUALLY BENEFICIAL PARTNERSHIPS HEALTH EQUITY AND DISPARITIES WILL BE ADDRESSED THROUGH THE FOLLOWING GOALS AND CATEGORIES OF STRATEGY:- GOAL: INCREASE UOFL HEALTH'S FOCUS ON AND UNDERSTANDING OF HEALTH EQUITY THROUGH DATA ANALYSIS, PLANNING, AND POLICY/PROCEDURE CHANGES TO ADDRESS HEALTH DISPARITIES STRATEGIES:- UTILIZE DATA TO BETTER UNDERSTAND THE NEED- BUILD INTERNAL SYSTEMS TO ADDRESS THE NEED - CONNECT PATIENTS TO RESOURCES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH- FOCUS ON REACHING UNDERSERVED POPULATIONS |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | THE ORGANIZATION HAS REPORTED BAD DEBT EXPENSE AT GROSS CHARGES WRITTEN OFF. THE ORGANIZATION'S BAD DEBT EXPENSE REPRESENTS AMOUNTS BILLED TO PATIENTS THAT WERE DEEMED UNCOLLECTIBLE AND DOES NOT INCLUDE ANY CHARGES THAT WERE ULTIMATELY REIMBURSED OR DISCOUNTED. PATIENT DISCOUNTS ARE RECORDED IN CONTRACTUAL ALLOWANCE OR FINANCIAL ASSISTANCE, AS APPROPRIATE, AS AN OFFSET TO GROSS REVENUE AND ARE NOT INCLUDED IN BAD DEBT EXPENSE. |
| PART III, LINE 3: | U OF L HEALTH - SHELBYVILLE, INC. HAS TAKEN REASONABLE AND PRUDENT STEPS TO ENSURE NO PORTION OF BAD DEBT COULD BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. |
| PART III, LINE 4: | SEE AUDITED FINANCIAL STATEMENTS PAGES 11-14. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS WERE TAKEN DIRECTLY OFF MEDICARE COST REPORT FILED WITH THE 6/30/23 YEAR END. |
| PART III, LINE 9B: | U OF L HEALTH - SHELBYVILLE INC.'S DEBT COLLECTION POLICY PROVIDES THAT THE HOSPITAL WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO THE HOSPITAL FOR APPROPRIATE FOLLOW-UP. U OF L HEALTH - SHELBYVILLE INC. REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL'S CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS:- NEITHER U OF L HEALTH - SHELBYVILLE INC. NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT,- NEITHER U OF L HEALTH - SHELBYVILLE INC. NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE, AND - U OF L HEALTH - SHELBYVILLE INC.'S COLLECTION AGENCY MAY NOT SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. |
| PART VI, LINE 2: | THE CHNAS ARE THE PRIMARY METHOD USED BY THIS FACILITY FOR ASSESSING THE NEEDS OF THE COMMUNITY. HOWEVER, THROUGH HOSPITAL BOARD MEMBERS AND THE INVOLVEMENT OF HOSPITAL LEADERSHIP IN THE COMMUNITY, OTHER NEEDS CAN COME TO LIGHT THAT MAY HAVE ARISEN AFTER THE CHNA WAS COMPLETED. |
| PART VI, LINE 3: | NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM UOFL HEALTH ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO:- CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS;- NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND- PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE, <WWW.UOFLHEALTH.ORG> AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT.SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE UOFL HEALTH ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.UOFL HEALTH ORGANIZATIONS WILL PROVIDE FINANCIAL COUNSELING TO PATIENTS ABOUT THEIR BILLS RELATED TO EMCARE AND WILL MAKE THE AVAILABILITY OF SUCH COUNSELING KNOWN. IT IS THE RESPONSIBILITY OF THE PATIENT OR THE PATIENT'S GUARANTOR TO SCHEDULE CONSULTATIONS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE WITH A FINANCIAL COUNSELOR. |
| PART VI, LINE 4: | SHELBYVILLE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES SHELBY COUNTY WHICH HAS A POPULATION OF APPROXIMATELY 49,611 RESIDENTS AND COVERS ROUGHLY 386 SQUARE MILES, WITH THE LOCAL ECONOMY AND SURROUNDING AREAS FOCUSED ON MANUFACTURING, HEALTH CARE AND SOCIAL ASSISTANCE, AND RETAIL TRADE. THE MEDIAN AGE IN SHELBY COUNTY IS 39.4. THE MEDIAN AGE FOR THE UNITED STATES IS 38.3 YEARS. THE NUMBER OF PERSONS PER HOUSEHOLD IN SHELBY COUNTY IS 2.77. THE U.S. AVERAGE NUMBER OF PERSONS PER HOUSEHOLD IS 2.60. RACE IN SHELBY COUNTY IS AS FOLLOWS: 80.1% NON-HISPANIC WHITE, 6.8% BLACK OR AFRICAN AMERICAN, 1.1% ASIAN, 0.2% NATIVE AMERICAN OR PACIFIC ISLANDER, AND 2.2% FROM TWO OR MORE RACES. 9.6% OF THE POPULATION WERE HISPANIC OR LATINO OF ANY RACE. THE RATIO OF PATIENTS TO PRIMARY CARE PHYSICIANS IN SHELBY COUNTY IS 2,850 PATIENTS TO 1. THE KENTUCKY AVERAGE IS 1,540 TO 1. THE OVERALL HEALTH RANKING FOR SHELBY COUNTY IS 9 OUT OF 120 WITH THE OVERALL STATE RANKING BEING 47TH OUT OF 50 STATES. |
| PART VI, LINE 5: | UOFL HEALTH SHELBYVILLE, INC. WORKS TO ENHANCE THE HEALTH OF THE COMMUNITY. MOST COMMUNITY OUTREACH IS OPEN TO THE PUBLIC AND SERVES THE BROADER COMMUNITY. THE FOLLOWING PROVIDES A SNAPSHOT OF THE HOSPITAL'S ENGAGEMENT WITH THE COMMUNITY. - FACILITATION OF HEALTH FAIRS IN THE LOCAL COMMUNITY- PARTNERSHIP WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT- MONITORING HOSPITAL PROVIDE OPIATE PRESCRIBING PRACTICES - INVOLVEMENT OF HOSPITAL LEADERSHIP ON HEALTH-RELATED AND SOCIAL SERVICE BOARDS, COMMITTEES, AND ADVISORY GROUPS- FACILITATING CONVERSATIONS RELATED PATIENTS' EXPERIENCES WITH THE SOCIAL DETERMINANTS OF HEALTH SUCH AS TRANSPORTATION- INVOLVEMENT IN THE EDUCATION OF HEALTH PROFESSIONALS THROUGH CLINICAL ROTATIONS AND CAPSTONES- INVOLVEMENT IN SMOKING CESSATION EFFORTS IN THE COMMUNITY- PARTNERSHIP WITH MERCY MEDICAL CLINIC AND NCDHD ON ACCESS TO CARE- ASSISTING PATIENTS WITH INSURANCE ENROLLMENT- DISCHARGE PLANNING THAT INCLUDES STREAMLINED PRIMARY CARE ACCESS- PARTNER WITH PEACE HOSPITAL TO INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES- AVAILABILITY OF REGISTERED DIETICIAN AND DIABETES EDUCATORS- PARTNERING WITH NURSING HOMES, ASSISTED LIVING FACILITIES, AND HOME HEALTH ORGANIZATIONS TO BETTER UNDERSTAND THE NEEDS AND RESOURCES AVAILABLE- COVID TESTING AND VACCINATIONS |
| PART VI, LINE 6: | UOFL HEALTH, INC. IS THE PARENT ORGANIZATION FOR A NUMBER OF TAX-EXEMPT HOSPITALS AND HEALTH CARE ORGANIZATIONS. ITS GENERAL PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF EACH ENTITY DIRECTLY OR INDIRECTLY CONTROLLED BY IT AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)3. UOFL HEALTH, INC. IS SUPERVISED OR CONTROLLED IN CONNECTION WITH ITS SUPPORTED ORGANIZATIONS BECAUSE THE SAME PEOPLE MANAGE UOFL HEALTH, INC. AND THE SUPPORTED ORGANIZATIONS. THE SUPPORTED ORGANIZATIONS INCLUDE UNIVERSITY MEDICAL CENTER, INC., UNIVERSITY OF LOUISVILLE PHYSICIANS, INC, AND UOFL HEALTH-LOUISVILLE, INC., ALL OF WHICH ARE KENTUCKY, NONPROFIT CORPORATIONS RECOGNIZED BY THE IRS AS BEING TAX-EXEMPT UNDER SECTION 501(C)3 OF THE CODE. UOFL HEALTH-LOUISVILLE, INC. INCLUDES FOUR HOSPITALS IN THE LOUISVILLE METRO AREA INCLUDING JEWISH HOSPITAL, MARY AND ELIZABETH HOSPITAL, PEACE HOSPITAL, AND FRAZIER REHABILITATION INSTITUTE. UOFL HEALTH IS DEDICATED TO COMMUNITY HEALTH PROMOTION AND IMPROVEMENT, WHICH IS PRESENT THROUGHOUT EACH OF ITS HOSPITALS AND SERVICE LINES. EACH OF THE SUPPORTED ORGANIZATIONS CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND THE CORRESPONDING HOSPITALS DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THOSE NEEDS. BEYOND THE CHNA PROCESS, MANY SERVICE LINES, PROGRAMS, AND FACILITIES THROUGHOUT THE UOFL HEALTH SYSTEM HAVE A COMMUNITY HEALTH COMPONENTS SUCH THAT THEY PROVIDE OUTREACH, HEALTH LITERACY, ACCESS TO CARE FOR UNDERSERVED POPULATIONS, AND CHRONIC DISEASE MANAGEMENT AND PREVENTION. |
| FORM 990, SCHEDULE H, PART VI, LINE 7 | A COMMUNITY BENEFIT REPORT IS NOT REQUIRED IN THE STATE OF KENTUCKY. THERE WAS A TRANSITION IN COMMUNITY BENEFIT STAFF IN THE 2022 YEAR WITH A SIGNIFICANT AMOUNT OF TIME WHERE THERE WERE NO STAFF TO COMPILE A REPORT. A REPORT WILL BE PRODUCED ON A REGULAR BASIS STARTING WITH THE 2023 FISCAL YEAR. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS D MILLER | ||||||||||||||
| PRESIDENT/CEO UOFL HEALTH | $0 | $1,076,144 | $0 | $537,104 | $0 | $10,257 | $0 | $10,675 | $0 | $19,639 | $0 | $1,653,819 | $0 | $0 |
| MICHAEL DOUZUK JR | ||||||||||||||
| CFO UOFL HEALTH (END 2023) | $0 | $631,792 | $0 | $302,442 | $0 | $16,639 | $0 | $10,675 | $0 | $22,659 | $0 | $984,207 | $0 | $0 |
| KEN MARSHALL | ||||||||||||||
| COO UOFL HEALTH | $0 | $610,294 | $0 | $313,913 | $0 | $25,831 | $0 | $10,675 | $0 | $2,822 | $0 | $963,535 | $0 | $0 |
| ANDREW DUFFEE MD | ||||||||||||||
| VICE CHAIR | $0 | $816,560 | $0 | $40,247 | $0 | $1,260 | $0 | $29,038 | $0 | $26,148 | $0 | $913,253 | $0 | $0 |
| CHRISTOPHER THEUER MD | ||||||||||||||
| MEMBER (TERM END 11/22) | $0 | $515,863 | $0 | $30,074 | $0 | $5,544 | $0 | $18,223 | $0 | $24,432 | $0 | $594,136 | $0 | $0 |
| KIRK STRACK | ||||||||||||||
| CFO UOFL HEALTH | $0 | $320,713 | $0 | $172,118 | $0 | $15,580 | $0 | $10,675 | $0 | $19,134 | $0 | $538,220 | $0 | $0 |
| VALERIE BRIONES-PRYOR MD | ||||||||||||||
| CHAIR | $0 | $478,085 | $0 | $0 | $0 | $1,108 | $0 | $17,508 | $0 | $26,596 | $0 | $523,297 | $0 | $0 |
| TIMOTHY AARON GAROFOLA | ||||||||||||||
| CEO SHELBYVILLE HOSPITAL | $0 | $296,216 | $0 | $150,822 | $0 | $644 | $0 | $10,920 | $0 | $25,031 | $0 | $483,633 | $0 | $0 |
| GREG PFISTER MD | ||||||||||||||
| MEMBER (TERM BEG) | $0 | $419,014 | $0 | $0 | $0 | $189 | $0 | $14,002 | $0 | $4,032 | $0 | $437,237 | $0 | $0 |
| ANNESSA BAKER | ||||||||||||||
| COO/CNO | $0 | $160,514 | $0 | $40,430 | $0 | $1,371 | $0 | $6,422 | $0 | $7,589 | $0 | $216,326 | $0 | $0 |
| KENNETH GARDNER MD | ||||||||||||||
| MEMBER | $0 | $166,718 | $0 | $15,092 | $0 | $4,481 | $0 | $5,743 | $0 | $18,548 | $0 | $210,582 | $0 | $0 |
| JAMES BOSE | ||||||||||||||
| DIRECTOR - IMAGING SERVICE | $0 | $113,945 | $0 | $18,767 | $0 | $1,808 | $0 | $2,266 | $0 | $23,569 | $0 | $160,355 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THERE IS A SHORT TERM INCENTIVE PLAN THAT ELIGIBLE UOFL HEALTH - SHELBYVILLE INC. EMPLOYEES MAY RECEIVE BASED ON MEETING CERTAIN BENCHMARKS. THE PLAN IS BASED ON MEETING FINANCIAL GOALS, DESIRED PATIENT QUALITY OUTCOMES, PATIENT SATISFACTION SCORES AND IS CONSISTENT WITH MARKET PRACTICES AND THE ORGANIZATION'S COMPENSATION PHILOSOPHY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | U OF L HEALTH, INC., A KENTUCKY NONPROFIT CORPORATION, SHALL BE THE HOSPITAL'S SOLE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | AFTER REVIEW BY THE ORGANIZATION'S FINANCE DEPARTMENT, THE CONTRACTED TAX PROFESSIONAL FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | IT IS THE POLICY OF THE HOSPITAL THAT AN INTERESTED PERSON WHO KNOWS THAT HE OR SHE HAS AN ACTUAL OR APPARENT CONFLICT OF INTEREST SHALL DISCLOSE IT PROMPTLY AND FULLY TO ALL NECESSARY PARTIES WHENEVER IT OCCURS. INTERESTED PERSONS ARE (A) VOTING MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS AND VOTING MEMBERS OF COMMITTEES THAT EXERCISE BOARD-DELEGATED AUTHORITY, (B) OFFICERS OF THE HOSPITAL ELECTED OR APPROVED BY THE BOARD OF DIRECTORS OR (C) A "CONTROLLED ENTITY" IN WHICH AT LEAST 35% OF THE CONTROL OR BENEFICIAL INTEREST IS HELD BY ANY ONE OR COMBINATION OF INDVIDUALS DESCRIBED IN A AND B. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER KNOWN INTEREST IN A PROPOSED TRANSACTION TO THE DIRECTORS AND MEMBERS OF COMMITTE WITH BOARD DELEGATED POWERS CONSIDERING THE TRANSATION OR ARRANGEMENT WHEN A CONFLICT OF INTEREST IS DECLARED. THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE PROPOSED TRANSACTION. THE INTERESTED PERSON SHALL LEAVE THE MEETING AND THE VOTE ON ANY TRANSACTIONS INVOLVING THE CONFLICT OF INTEREST THE MINUTES OF THE BOARD WILL CONTAIN THE NAMES OF THE PERSONS WHO DISCLOSE OR OTHERWISE WERE FOUND TO HAVE INTEREST IN CONNECTION WITH A CONFLICT OF INTEREST, THE NATURE OF THE INTEREST AND ANY ACTION TAKEN TO DETERMINE THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | LINE 15A: BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. THE HOSPITAL USES THE MERCER GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE MERCER GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO THE HOSPITAL'S COMPENSATION PHILOSOPHY AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY MERCER GROUP TO THE COMPENSATION COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS ANNUALLY. LINE 15B: FOR ALL EXECUTIVE DIRECTORS, TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES, THE FOLLOWING PROCESS IS USED. 1) HUMAN RESOURCES (HR) HAS INDEPENDENT COMPANY DO A COMPARISON OF LIKE POSITIONS WITHIN THE COMMUNITY AND COME UP WITH A RANGE. THEY PREPARE A PROPOSAL THAT IS SUBMITTED TO HR FOR REVIEW 2) A SALARY IS DETERMINED WITHIN THAT RANGE BASED ON YEARS OF SERVICE EDUCATION AND OTHER FACTORS, SUCH AS ADDITIONAL RESPONSIBILITIES. HR PREPARES A PROPOSAL TO SUBMIT TO THE CEO 3)THE PROPOSAL, CONTAINING THE POSITION, RANGE AND FINAL COMPENSATION IS TURNED OVER TO THE CEO FOR REVIEW 4) AFTER REVIEW, THE CEO TAKES THE PROPOSAL INFORMATION AND PRESENTS IT TO THE FINANCE COMMTTEE. 5) THE FINANCE COMMITTEE DECIDES AND VOTES ON THE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION B | U OF L HEALTH - SHELBYVILLE, INC. DOES NOT ISSUE ANY 1099S UNDER ITS EIN. ALL INDEPENDENT CONTRACTORS ARE PAID BY RELATED ORGANIZATION UNIVERSITY MEDICAL CENTER UNDER A COMMON PAYMASTER ARRANGEMENT. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,547,356. MANAGEMENT AND GENERAL EXPENSES 1,364,954. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,912,310. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,056,853. MANAGEMENT AND GENERAL EXPENSES 297,648. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,354,501. |
| FORM 990, PART XI, LINE 9: | TRANSFERS TO/FROM AFFILIATES 4,789,215. |
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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY MEDICAL CENTER INC | |||||||||||
| 530 S JACKSON STREET | LOUISVILLE | KY | 40202 | 611293786 | HOSPITAL | KY | 501(C)(3) | LINE 3 | U OF L HEALTH INC | 0 | |
| U OF L HEALTH INC | |||||||||||
| 530 S JACKSON STREET | LOUISVILLE | KY | 40202 | 843125292 | SUPPORTING ORG | KY | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| U OF L HEALTH - LOUISVILLE INC | |||||||||||
| 200 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 843178470 | HOSPITAL | KY | 501(C)(3) | LINE 3 | U OF L HEALTH INC | 0 | |
| UNIVERSITY OF LOUISVILLE PHYSICIANS LLC | |||||||||||
| 300 EAST MARKET ST 400 | LOUISVILLE | KY | 40202 | 273645560 | MEDICAL SERVICES | KY | 501(C)(3) | LINE 10 | U OF L HEALTH INC | 0 | |
| UNIVERSITY OF LOUISVILLE INC | |||||||||||
| 2301 S 3RD STREET | LOUISVILLE | KY | 40292 | 611014882 | EDUCATION | KY | 501(C)(3) | 0 | N/A | ||
| U OF L HEALTH FOUNDATION INC | |||||||||||
| 530 S JACKSON STREET | LOUISVILLE | KY | 40202 | 863084814 | SUPPORTING ORG | KY | 501(C)(3) | LINE 7 | UNIVERSITY MEDICAL CENTER | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |