COMMONWEALTH REGIONAL SPECIALTY HOSPITAL INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL INC (EIN 54-2142034)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2023-02-15
- IRS object ID
- 202330469349301653
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-02-15T10:07:11-06:00 | ReturnTs |
| Tax Period End | 2022-03-31 | 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 | 3102 WEST END AVENUE SUITE 800 | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 372031382 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 542142034 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMONWEALTH REGIONAL SPECIALTY | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JENNY GREENWELL | InCareOfNm |
| Business Name Control | COMM | 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 | 2022-08-15 | 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 | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-03-07 01:45:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRISTA ATKINS | 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 | $9,239,531 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | medcenterhealth.org/location/commonwealth-reg | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL IS DESIGNED TO MEET MEDICAL, THERAPEUTIC AND FAMILIAL NEEDS RELATED TO PROVIDING LONG-TERM ACUTE CARE SERVICES FOR INDIVIDUALS WITH CRITICAL DISEASES OR DISORDERS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 54 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $53,586 | PYContributionsGrantsAmt |
| CY Contributions Grants | $294,377 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,775,716 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,793,539 | CYProgramServiceRevenueAmt |
| PY Investment Income | $31,920 | PYInvestmentIncomeAmt |
| CY Investment Income | $42,376 | CYInvestmentIncomeAmt |
| PY Other Revenue | $139 | PYOtherRevenueAmt |
| CY Other Revenue | $261 | CYOtherRevenueAmt |
| PY Total Revenue | $7,861,361 | PYTotalRevenueAmt |
| CY Total Revenue | $8,130,553 | 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 | $4,105,755 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,949,468 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,376,008 | PYOtherExpensesAmt |
| CY Other Expenses | $3,980,146 | CYOtherExpensesAmt |
| PY Total Expenses | $7,481,763 | PYTotalExpensesAmt |
| CY Total Expenses | $7,929,614 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $379,598 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $200,939 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,816,435 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,028,714 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,741,479 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,797,958 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,074,956 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,230,756 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE HOSPITAL IS DESIGNED TO MEET THE MEDICAL, THERAPEUTIC AND FAMILIAL NEEDS RELATED TO PROVIDING LONG-TERM ACUTE CARE SERVICES REQUIRED BY INDIVIDUALS WITH CRITICAL DISEASE OR DISORDERS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,160,178 | ExpenseAmt |
| Revenue | $7,793,539 | RevenueAmt |
| Desc | COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) PROVIDES LONG-TERM ACUTE CARE SERVICES IN THE COMMUNITY OF BOWLING GREEN, WARREN COUNTY, KENTUCKY. CRSH PROVIDES MEDICAL TREATMENT AND REHABILITATION TO CHRONICALLY AND/OR CRITICALLY ILL PATIENTS IN ITS 16 BED LONG-TERM ACUTE CARE FACILITY. DURING FISCAL YEAR 2022, CRSH ADMITTED 202 PATIENTS AND PROVIDED 4,914 DAYS OF PATIENT CARE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
| Total Program Service Expenses | $7,160,178 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 54 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | false | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | 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 | PO BOX 9876 800 PARK STREET | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MS CONNIE D SMITH | ||||||||||
| PRESIDENT / CEO | 2.0 | 52.0 | Yes (X) | $0 | $1,333,801 | $20,856 | ||||
| MR WADE STONE | ||||||||||
| EXECUTIVE VICE PRESIDENT | 2.0 | 48.0 | Yes (X) | $0 | $434,345 | $29,943 | ||||
| MR DAVID GRAY | ||||||||||
| EXECUTIVE VICE PRESIDENT | 2.0 | 48.0 | Yes (X) | $0 | $374,445 | $43,440 | ||||
| MS MICHELE LAWLESS | ||||||||||
| EXECUTIVE VICE PRESIDENT / CFO | 2.0 | 48.0 | Yes (X) | $0 | $371,796 | $3,505 | ||||
| MR ERIC HAGAN | ||||||||||
| VP OF RURAL HOSPITALS | 4.0 | 36.0 | $28,878 | $259,906 | $20,046 | Yes (X) | ||||
| MR RONALD G SOWELL | ||||||||||
| EVP/CFO - RETIRED 3/31/2021 | 2.0 | 48.0 | $0 | $270,499 | $5,145 | Yes (X) | ||||
| MS JILL PAYNE | ||||||||||
| EVP/CNO - RESIGNED 6/25/2021 | 2.0 | 48.0 | Yes (X) | $0 | $166,490 | $6,935 | ||||
| MS ELIZABETH SCHMIDT | ||||||||||
| PHARMACY MANAGER | 40.0 | 0.0 | $107,488 | $0 | $39,819 | Yes (X) | ||||
| MS CHRISTA ATKINS | ||||||||||
| ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $91,937 | $0 | $22,220 | ||||
| DR D GHAYTH HAMMAD | ||||||||||
| DIRECTOR | 2.0 | 0.0 | $8,636 | $0 | $0 | Yes (X) | ||||
| MR TOM FORTE | ||||||||||
| DIRECTOR | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||||
| MR TOMMY HOLDERFIELD | ||||||||||
| CHAIRMAN | 2.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| MS CHERI NATCHER | ||||||||||
| DIRECTOR | 2.0 | 4.0 | $0 | $0 | $0 | Yes (X) | ||||
| MS SUSAN JONES | ||||||||||
| DIRECTOR | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||||
| MS VICKIE ELROD | ||||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| MR JOE DAVIS | ||||||||||
| VICE CHAIR | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| DR MUHAMMAD AHMED | ||||||||||
| DIRECTOR | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $236,939 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,211,282 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $191,909 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | QUALIVIS LLC | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | DEPARTMENT 3847 PO BOX 123847 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 753123847 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | STAFFING SERVICES | ServicesDesc |
| Compensation | $256,623 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $6 | RelatedOrganizationsAmt |
| Government Grants | $294,371 | GovernmentGrantsAmt |
| Total Contributions | $294,377 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INPATIENT SVCS PROVIDED | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $7,793,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,793,539 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,793,539 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,968 | TotalRevenueColumnAmt |
| Exclusion | $7,968 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,143,386 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,108,978 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $34,408 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,408 | TotalRevenueColumnAmt |
| Exclusion | $34,408 | ExclusionAmt |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC. INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $261 | TotalRevenueColumnAmt |
| Exclusion | $261 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $261 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,130,553 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,793,539 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $42,637 | 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 | $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 | $30,883 | TotalAmt |
| Management And General | $30,883 | 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 | $2,946,849 | TotalAmt |
| Program Services | $2,710,611 | ProgramServicesAmt |
| Management And General | $236,238 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,239 | TotalAmt |
| Program Services | $178,635 | ProgramServicesAmt |
| Management And General | $17,604 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,389 | TotalAmt |
| Program Services | $506,478 | ProgramServicesAmt |
| Management And General | $49,911 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,108 | TotalAmt |
| Program Services | $199,445 | ProgramServicesAmt |
| Management And General | $19,663 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,600 | TotalAmt |
| Management And General | $291,600 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,585 | TotalAmt |
| Management And General | $37,585 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,435 | TotalAmt |
| Management And General | $24,435 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,593 | TotalAmt |
| Management And General | $1,593 | ManagementAndGeneralAmt |
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 | $1,447,706 | TotalAmt |
| Program Services | $1,438,655 | ProgramServicesAmt |
| Management And General | $9,051 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465 | TotalAmt |
| Management And General | $465 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,521 | TotalAmt |
| Program Services | $161,861 | ProgramServicesAmt |
| Management And General | $6,660 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,827 | TotalAmt |
| Program Services | $42,827 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,210 | TotalAmt |
| Program Services | $251,318 | ProgramServicesAmt |
| Management And General | $23,892 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $1,231 | TotalAmt |
| Management And General | $1,231 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,853 | TotalAmt |
| Program Services | $28,804 | ProgramServicesAmt |
| Management And General | $49 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,815 | TotalAmt |
| Program Services | $71,126 | ProgramServicesAmt |
| Management And General | $3,689 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,241,880 | $1,241,880 | |
| OTHER TAXES AND LICENSE | $324,652 | $324,636 | $16 |
| DUES & SUBSCRIPTIONS | $9,136 | $9,136 | |
| RECRUITING FEES | $7,438 | $1,703 | $5,735 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,199 | TotalAmt |
| Program Services | $2,199 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,929,614 | TotalAmt |
| Program Services | $7,160,178 | ProgramServicesAmt |
| Management And General | $769,436 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,928,179 | BOYAmt |
| EOY | $1,734,532 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,163,224 | BOYAmt |
| EOY | $990,029 | 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 | $1,689,784 | BOYAmt |
| EOY | $1,459,730 | 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 | $98,874 | BOYAmt |
| EOY | $91,993 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,803 | BOYAmt |
| EOY | $48,792 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $940,245 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $789,142 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,936 | BOYAmt |
| EOY | $151,103 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | 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 | $0 | 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 | $709,635 | BOYAmt |
| EOY | $552,535 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,816,435 | BOYAmt |
| EOY | $5,028,714 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,955,290 | BOYAmt |
| EOY | $1,280,651 | 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 | $786,189 | BOYAmt |
| EOY | $517,307 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,741,479 | BOYAmt |
| EOY | $1,797,958 | 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 | $3,074,956 | BOYAmt |
| EOY | $3,230,756 | 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 | $3,074,956 | BOYAmt |
| EOY | $3,230,756 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,816,435 | BOYAmt |
| EOY | $5,028,714 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $200,939 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$45,139 | NetUnrlzdGainsLossesInvstAmt |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $1,593 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,593 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SECTION C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | LOBBYING ACTIVITIES ------------------- THE CORPORATION IS A MEMBER OF THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS. OF THE DUES PAID TO THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS, $1,593 WAS ALLOCATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
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 | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $937,395 | OtherCostOrOtherBasisAmt |
| Depreciation | $786,292 | DepreciationAmt |
| Book Value | $151,103 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,850 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,850 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $151,103 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RIGHT OF USE ASSETS - LEASES | $427,165 |
| AMOUNTS DUE FROM MEDICAID | $65,914 |
| MEDICAID HRIP RECEIVABLE | $59,456 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $552,535 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $104,583 |
| LEASE LIABILITIES | $412,724 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $517,307 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $8,085,414 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$45,139 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$45,139 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,130,553 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $8,130,553 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,929,614 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $7,929,614 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $7,929,614 | 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 | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | 2 | PersonsServedCnt |
| Total Community Benefit Expns | $244,215 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $244,215 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04630 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 40 | PersonsServedCnt |
| Total Community Benefit Expns | $244,215 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $244,215 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04630 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $94,573 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $94,573 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1 | PersonsServedCnt |
| Total Community Benefit Expns | $24,523 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,523 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1 | PersonsServedCnt |
| Total Community Benefit Expns | $119,096 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $119,096 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01560 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 41 | PersonsServedCnt |
| Total Community Benefit Expns | $363,311 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $363,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $39,778 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,369,670 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,001,790 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$632,120 | 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 | COMMONWEALTH REGIONAL SPECIALTY HOSPI | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 PARK STREET | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | COMMONWEALTHREGIONALSPECIALTYHOSPITAL.OR | WebsiteAddressTxt |
| State License | 100404 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMONWEALTH REGIONAL SPECIALTY HOSPI | 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 | false | CHNAConductedInd |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| 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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT ----------------------------- IN SEPTEMBER 2011, COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) JOINED WITH THE BARREN RIVER DISTRICT HEALTH DEPARTMENT AND NUMEROUS OTHER HEALTHCARE PROVIDERS, COMMUNITY ORGANIZATIONS AND LEADERS TO FORM THE BARREN RIVER COMMUNITY HEALTH PLANNING COUNCIL. THE GOAL OF THE COUNCIL WAS TO RECOGNIZE AND SERVE THOSE MOST IN NEED IN ORDER TO BENEFIT THE WHOLE COMMUNITY. THE COUNCIL IMPLEMENTED A COMMUNITY HEALTH NEEDS SURVEY AND ASSESSMENT PROCESS. KEY HEALTHCARE NEEDS FOR THE COMMUNITY WERE IDENTIFIED FOLLOWED BY THE DEVELOPMENT OF STRATEGIC PLANS TO MEET THOSE NEEDS. THE PROCESS USED WAS PRIMARILY BASED ON THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP), WHICH WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. COMMUNITY #1 AND #2 SURVEYS WERE CONDUCTED IN 2011 AND 2015. COMMONWEALTH REGIONAL SPECIALTY HOSPITAL USED THE DATA COLLECTED THROUGH THE SURVEYS TO DEVELOP STRATEGIC PLANS THAT ADDRESSED STRENGTHENING PARTNERSHIPS WITH COMMUNITY HEALTH PROVIDERS AND ORGANIZATIONS, PREVENTATIVE CARE AND DISEASE MANAGEMENT AND ACCESS TO CARE. DURING THE FALL AND WINTER OF 2014-15, THE COUNCIL WAS RENAMED THE BARREN RIVER INITIATIVE TO GET HEALTHY TOGETHER (BRIGHT) COALITION. CYCLE 3 OF THE COMMUNITY ASSESSMENT WAS INITIATED IN THE SPRING OF 2018 BY THE BRIGHT COALITION. BRIGHT MEMBERS WERE RESTRUCTURED INTO FOUR SUBCOMMITTEES BASED ON THE SOCIAL DETERMINANTS OF HEALTH FRAMEWORK. THESE AREAS INCLUDED HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS; AND PHYSICAL ENVIRONMENT. BRIGHT MEMBERS JOINED THE GROUP THEY MOST CLOSELY IDENTIFIED WITH PROFESSIONALLY. GAPS AND ASSETS FOR THE NEWLY FORMED GROUP'S AREA OF FOCUS WERE IDENTIFIED FOR EACH OF THE 10 COUNTIES. FROM THERE, EACH OF THE GROUPS DEVELOPED CHNA SURVEY QUESTIONS AND PROVIDED FEEDBACK THAT THEY FELT WOULD IDENTIFY THE COMMUNITY NEEDS IN THEIR SPECIFIC FOCUS AREA. THE SURVEY WAS DISSEMINATED, USING BOTH PAPER AND ELECTRONIC VERSIONS, SEPTEMBER 1 - NOVEMBER 31, 2018 TO ALL 10 COUNTIES IN THE BRADD AREA. THE SURVEY WAS PLACED IN FREESTANDING HEALTH CLINICS, LIBRARIES, HOSPITALS, UK EXTENSION OFFICE LOCATIONS, DISTRIBUTED AT HEALTH FAIRS, DISTRIBUTED TO 50,000 HOMES VIA THE MED CENTER HEALTH WELLNESS PUBLICATION WITH PAID POSTAGE RETURN, PLACED IN THE BOWLING GREEN DAILY NEWS NEWSPAPER AND PROVIDED TO LOCAL HOUSING AUTHORITIES. THE GOAL WAS TO HAVE AS MANY DIFFERENT POPULATIONS REPRESENTED IN THE BRADD AREA RESPOND TO THE SURVEY AS POSSIBLE. THE UNDERSERVED POPULATIONS WERE ESPECIALLY A FOCUS AS FAR AS A DESIRED GROUP OF SURVEY RESPONDENTS. THE SURVEYS WERE ANALYZED BY THE BARREN RIVER AREA HEALTH DEPARTMENT. AFTER REVIEWING THE DATA COLLECTED, IT WAS DETERMINED BY THE BRIGHT COALITION THAT THERE WAS NOT ENOUGH REPRESENTATION OF THE UNDERSERVED POPULATION. EACH OF THE FOUR BRIGHT WORKGROUPS DETERMINED WHERE THE UNDERSERVED POPULATION COULD POTENTIALLY BE REACHED AND WHICH SPECIFIC TOPIC(S) OF THE SURVEY THEY WANTED TO NARROW IN ON TO COLLECT MORE INFORMATION. ADDITIONAL QUESTIONS WERE DEVELOPED TO SURVEY THE SPECIFIC POPULATIONS EITHER INDIVIDUALLY OR IN A FOCUS GROUP SETTING. IT WAS ALSO DETERMINED THAT IT WOULD BE BENEFICIAL TO ASK PROFESSIONALS THAT WORK WITH THESE POPULATIONS OF PEOPLE TO DETERMINE BARRIERS THEY ENCOUNTER WHEN TRYING TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE. CRSH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSEMENT FOR THE APRIL 2022 THROUGH MARCH 2025 TIME PERIOD THAT CAN BE FOUND ON ITS WEBSITE MEDCENTERHEALTH.RG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. THE INFORMATION PRESENTED IN THIS FORM 990 IS FOR THE ASSESSMENT THAT WAS MADE FOR THE TIME PERIOD THAT ENDED MARCH 31, 2021. |
| SCHEDULE H, PART V, SECTION B, LINE 6A | OTHER HOSPITAL FACILITIES ----------------------------------------- OTHER FACILITIES THE HOSPITAL'S CHNA WAS CONDUCTED WITH INCLUDE THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER), THE MEDICAL CENTER AT FRANKLIN, MONROE COUNTY MEDICAL CENTER, AND TJ SAMSON COMMUNITY HOSPITAL. A FULL LIST OF THESE ORGANIZATIONS CAN BE FOUND ON PAGE 3 OF THE BRIGHT COALITION COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN 2019-2021 LOCATED AT HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. WITHIN BRIGHT, THESE STAKEHOLDERS JOINED FORCES TO DETERMINE HOW LEADERS OF SOUTH-CENTRAL KENTUCKY'S RURAL COMMUNITIES CAN WORK TOGETHER TO IMPROVE OVERALL HEALTH STATUSES, STRENGTHEN THE LOCAL ECONOMY, CONTRIBUTE TO EDUCATION SUCCESSES, AND IMPROVE THE QUALITY OF LIFE FOR ALL. |
| SCHEDULE H, PART V, SECTION B, LINES 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 13B & 13H | ELIGIBILITY CRITERIA ------------------------ Line 13B 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 ALSO APPLY THE FOLLOWING GUIDELINES TO CHARITY 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 PER THE ASSET TEST ABOVE. 4) WE 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 CFR. 5) THE PAYMENTS ARE TREATED AS LONG-TERM PAY, I.E. THEY REQUIRE A WRITTEN AGREEMENT, AND THE PAYMENTS WILL BE INTEREST FREE FOR THE REMAINING PORTION OF THE BALANCE DUE. Line 13H Other criteria -------------------------------- PERSONS OR FAMILIES THAT QUALIFY FOR MEDICAID, FOOD STAMPS, AND OTHER INDIGENT CARE PROGRAMS THAT CAN BE AND ARE INDEPENDENTLY VERIFIED ARE DEEMED TO MEET THE FINANCIAL ASSISTANCE GUIDELINES, AS WILL ACCOUNTS IDENTIFIED THROUGH TOOLS OR PROGRAMS WHICH PROVIDE REASONABLE ASSURANCE THAT THE OBLIGATION MEETS OUR FINANCIAL ASSISTANCE GUIDELINES. PATIENT ACCOUNTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THE PATIENT WAS ELIGIBLE FOR MEDICAID WITHIN 60 DAYS BEFORE OR AFTER THE DISCHARGE DATE/DATE OF SERVICE. |
| SCHEDULE H, PART V, LINE 16A, 16B, & 16C | FAP WEBSITE ------------- A COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), 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 (14 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 USES ASSET LEVELS, UNINSURED, UNDERINSURED, MEDICAID 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 MADE AVAILABLE TO THE PUBLIC VIA NEWSPAPER INSERTS, DIRECT MAILINGS, AND IS POSTED ON COMMONWEALTH HEALTH CORPORATION'S WEBSITE AT: HTTPS://MEDCENTERHEALTH.ORG/ABOUT-US/ |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY --------------------- A COST ACCOUNTING SYSTEM WAS USED FOR CALCULATIONS ON IRS WORKSHEETS 1 AND 3. THE COSTS RELATED TO MEDICAID PATIENTS WERE DETERMINED USING A COST ACCOUNTING SYSTEM. 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 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, 2022. 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 DEBT 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 COST ACCOUNTING SYSTEM, WHICH ARE BASED UPON COST ACCOUNTING STANDARD PRINCIPALS OF ALLOCATING DIRECT AND INDIRECT EXPENSES TO SERVICES PERFORMED. |
| SCHEDULE H, PART III, LINE 9B | DEBT COLLECTION PRACTICES -------------------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE CRSH DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, REVENUE IS NOT RECORDED FOR SUCH SERVICES. CRSH 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 UNCOMPENSATED 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 AND THE COSTS OF TREATING MEDICAID BENEFICIARIES IN EXCESS OF GOVERNMENT PAYMENTS. CRSH 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 ----------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL ("CRSH") IS BUILT UPON THE FOUNDATION OF SERVING OUR COMMUNITY, DAY IN AND DAY OUT, WITH QUALITY DEPENDABLE HEALTHCARE. CRSH'S CHNA AND STRATEGIC IMPLEMENTATION PLAN ARE 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 PLAIN LANGUAGE SUMMARY OF OUR FINANCIAL ASSITANCE POLICY WITH INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE AND CONTACT INFORMATION FOR ADDITIONAL ASSISTANCE. SIGNAGE AND BROCHURES DESCRIBING FINANCIAL ASSITANCE POLICIES ARE AVAILABLE. ADDITIONALLY, THE POLICY AND APPLICATION ARE PUBLICLY AVAILABLE ON THE HOSPITAL'S WEBSITE. UNINSURED PATIENTS DISCUSS PAYMENT OPTIONS INCLUDING FINANCIAL ASSITANCE WITH FINANCIAL COUNSELORS WHO INFORM THESE PATIENTS ABOUT OUR POLICY AND ASSIST THEM IN APPLYING IF NECESSARY. SUBSEQUENT PATIENT STATEMENTS RECEIVED BY THE PATIENT CONTAIN INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION ---------------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL SERVES THE NEEDS OF PATIENTS AND PHYSICIANS OF BOWLING GREEN, KY AND SURROUNDING COUNTIES. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH ------------------------------ COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) FOCUSES ON TREATING COMPLEX, HIGH ACUITY PATIENTS WITH ADVANCED CLINICAL SKILLS, COMPASSION AND SENSITIVITY TO THE NEEDS OF THE PATIENT AND FAMILY. CRSH UTILIZES A MULTIDISCIPLINARY APPROACH, OFTEN NOT AVAILABLE IN THE SHORT STAY HOSPITAL. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM ------------------------------ COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) 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 CRSH) 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 LICENSED INDEPENDENTLY BY THE STATE OF KENTUCKY. THE MEDICAL CENTER AT BOWLING GREEN 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. 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, KENTUCKY. THE MEDICAL CENTER AT ALBANY: ------------------------ ON APRIL 1, 2016, COMMONWEALTH HEALTH CORPORATION, INC. (CHC) ACQUIRED THE NET ASSETS OF CLINTON COUNTY HOSPITAL, INC., AN ACUTE-CARE HOSPITAL. THE CORPORATION ASSIGNED THE NET ASSETS OF THE HOSPITAL TO ITS WHOLLY OWNED SUBSIDIARY, THE MEDICAL CENTER AT CLINTON COUNTY, INC., D/B/A THE MEDICAL CENTER AT ALBANY (MCA). MCA EARNS REVENUE BY PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO PATIENTS IN CLINTON COUNTY AND SURROUNDING COUNTIES IN KENTUCKY. COMMONWEALTH HEALTH FOUNDATION: ------------------------ CHC ENDORSED THE ESTABLISHMENT OF COMMONWEALTH HEALTH FOUNDATION ("THE FOUNDATION") FOR THE PURPOSE OF FOSTERING, SUPPORTING AND INITIATING ACTIVITIES FOR 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MR DAVID GRAY | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $0 | $366,071 | $0 | $0 | $0 | $8,374 | $0 | $8,700 | $0 | $34,740 | $0 | $417,885 | $0 | $0 |
| MR ERIC HAGAN | ||||||||||||||
| VP OF RURAL HOSPITALS | $28,209 | $253,883 | $0 | $0 | $669 | $6,023 | $0 | $0 | $2,005 | $18,041 | $30,883 | $277,947 | $0 | $0 |
| MS MICHELE LAWLESS | ||||||||||||||
| EXECUTIVE VICE PRESIDENT / CFO | $0 | $365,764 | $0 | $0 | $6,032 | $0 | $0 | $0 | $3,505 | $0 | $375,301 | $0 | $0 | |
| MS JILL PAYNE | ||||||||||||||
| EVP/CNO - RESIGNED 6/25/2021 | $0 | $162,535 | $0 | $0 | $0 | $3,955 | $0 | $2,381 | $0 | $4,554 | $0 | $173,425 | $0 | $0 |
| MS CONNIE D SMITH | ||||||||||||||
| PRESIDENT / CEO | $0 | $949,706 | $0 | $0 | $0 | $384,095 | $0 | $0 | $0 | $20,856 | $0 | $1,354,657 | $0 | $0 |
| MR RONALD G SOWELL | ||||||||||||||
| EVP/CFO - RETIRED 3/31/2021 | $0 | $260,389 | $0 | $0 | $0 | $10,110 | $0 | $0 | $0 | $5,145 | $0 | $275,644 | $0 | $0 |
| MR WADE STONE | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $0 | $381,149 | $0 | $0 | $0 | $53,196 | $0 | $0 | $0 | $29,943 | $0 | $464,288 | $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 - COMPENSTION 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 $365,712 WADE STONE $50,987 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS -------------------------------- COMMONWEALTH HEALTH CORPORATION (CHC) FORMED COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) IN 2003 TO MEET AN EXISTING NEED FOR LONG-TERM ACUTE CARE HOSPITAL SERVICES IN THE COMMUNITY OF BOWLING GREEN, WARREN COUNTY, KENTUCKY. CHC ALSO RECOGNIZED THE NEED OF THE CONTINUUM OF CARE TO PROVIDE AN APPROPRIATE VENUE FOR PATIENTS WHO NEEDED ACUTE SERVICES BEYOND THOSE GENERALLY AVAILABLE IN THE ACUTE CARE HOSPITAL SETTING. LONG-TERM ACUTE CARE HOSPITALS (AS RECOGNIZED BY 42 CFR 412.23 E) GENERALLY PROVIDE DIAGNOSTIC, MEDICAL, AND REHABILITATIVE TREATMENT FOR THOSE PATIENTS WITH CHRONIC AND COMPLEX MEDICAL CONDITIONS WHOSE AVERAGE LENGTH OF STAY IN THE HOSPITAL EXCEEDS 25 DAYS. CRSH IS PRIMARILY ENGAGED IN PROVIDING TO INPATIENTS, BY OR UNDER THE SUPERVISION OF PHYSICIANS, DIAGNOSTIC AND THERAPEUTIC SERVICES FOR MEDICAL DIAGNOSIS, TREATMENT AND CARE OF THOSE PATIENTS WITH CHRONIC ILLNESS AND COMPLEX MEDICAL NEEDS. IT MAINTAINS CLINICAL RECORDS ON ALL PATIENTS AND HAS BYLAWS IN EFFECT CONCERNING ITS STAFF OF PHYSICIANS. IT REQUIRES THAT EVERY PATIENT BE UNDER THE CARE OF A PHYSICIAN AND PROVIDES 24-HOUR NURSING SERVICE BY OR SUPERVISED BY A REGISTERED PROFESSIONAL NURSE, AND HAS A LICENSED PRACTICAL NURSE OR REGISTERED PROFESSIONAL NURSE ON DUTY AT ALL TIMES. IT HAS A HOSPITAL UTILIZATION REVIEW PLAN AND IS LICENSED OR IS APPROVED BY THE STATE OF KENTUCKY AS MEETING THE STANDARDS ESTABLISHED FOR SUCH LICENSING. IT ALSO MEETS OTHER HEALTH AND SAFETY REQUIREMENTS OF THE SECRETARY OF HEALTH AND HUMAN SERVICES. THIS HOSPITAL IS NOT PRIMARILY FOR THE CARE AND TREATMENT OF MENTAL DISEASES. SERVICES OFFERED INCLUDE: . ACUTE MEDICAL CARE . COMPLICATED WOUND CARE . RESPIRATORY THERAPY . LABORATORY SERVICES . PHARMACY SERVICES . VENTILATOR WEANING SERVICES . CARDIAC/CARDIOVASCULAR CONDITIONS SERVICES . RENAL INSUFFICIENCY, RENAL FAILURE, HEMODIALYSIS SERVICES . POST-TRAUMATIC STRESS WITH EXTENSIVE ACUTE MEDICAL NEEDS . EXTENDED INTENSIVE CARE NEEDS . RADIOLOGY SERVICES . LONG-TERM IV ANTIBIOTIC THERAPY . REHABILITATION NEEDS TO ACCOMPANY ACUTE MEDICAL CARE THE HOSPITAL'S PROFESSIONAL STAFF INCLUDES PHYSICIANS WHO ARE ENGAGED IN THE PRACTICE OF MEDICINE AND WHO REPRESENT MULTIPLE SPECIALTIES, INCLUDING BUT NOT LIMITED TO FAMILY PRACTICE, INTERNAL MEDICINE, PULMONARY, CARDIAC, RADIATION THERAPY, AND INFECTIOUS DISEASE. THE STAFF INCLUDES NURSES, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPISTS, RESPIRATORY THERAPISTS, PHARMACISTS, SOCIAL WORKERS, DIETITIANS, AND OTHERS. USING AN INTERDISCIPLINARY TEAM APPROACH, THE STAFF WORK COLLABORATIVELY TO PROVIDE CARE CONSISTING OF INPATIENT SERVICES OF A GENERAL AND SPECIALIZED NATURE FOR PATIENTS REQUIRING AN EXTENDED LENGTH OF STAY DUE TO THE CRITICAL NATURE OF THEIR ILLNESS. |
| 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 | POWER OF MEMBERS -------------------- BYLAWS OF THE CORPORATION SPECIFY THAT THE SOLE MEMBER SHALL APPOINT A NOMINATING COMMITTEE WHICH SHALL MEET AND DESIGNATE NOMINEES FOR BOARD DIRECTORSHIPS. |
| 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 POLICY 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 COMMITTEE (RCC) RENEWS AND APPROVES ALL CONTRACTS BETWEEN CHC AND/OR ITS AFFILIATES AND DISQUALIFIED ENTITIES. THE REVIEW IS DESIGNED TO IDENTIY 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 ----------------------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL 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. THE ENTITY 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. AON CONDUCTED THE FY22 REVIEW IN MARCH 2021. |
| 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:651 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING FEES TOTAL FEES:8400 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB FEES TOTAL FEES:1000 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:658927 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT FEES TOTAL FEES:232582 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:AGENCY NURSING FEES TOTAL FEES:546146 |
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 |
| COMMONWEALTH HEALTH FOUNDATION | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 611362000 | SUPPORT | KY | 501(C)(3) | 7 | CHC INC | false |
| COMMONWEALTH HEALTH FREE CLINIC | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 611292739 | HEALTH CARE | 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 HEALTH CORPORATION | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 311118087 | SUPPORT | KY | 501(C)(3) | 10 | NA | false |
| THE MEDICAL CENTER AT ALBANY | ||||||||||
| 800 PARK STREET | BOWLING GREEN | KY | 42101 | 811312058 | HOSPITAL | KY | 501(C)(3) | 3 | CHC INC | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MED PLAZA PRTS LTD | 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) |
|---|---|---|
| Predominant Income Type | NONE | PredominantIncomeTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | 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 |