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KNOXVILLE COMMUNITY HOSPITAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
KNOXVILLE COMMUNITY HOSPITAL INC (EIN 42-1087612)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-11
IRS object ID
202311319349303741
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

FieldValueIRS element (for citing)
Return2023-05-11T14:14:01-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line118081 BURT ST STE 200AddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP680224722ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421087612EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KNOXVILLE COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlKNOXBusinessNameControlTxt
Phone6418421407PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH LINCOLN STREETAddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50138ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMAGGIE HAMILTON-BEYERPersonNm
Person TitleCFOPersonTitleTxt
Phone6418421407PhoneNum
Signature2023-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMAGGIEPersonFirstNm
Person LastHAMILTON-BEYERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMEGAN L KOZIOL CPAPreparerPersonNm
PTINP01544037PTIN
Phone4023302660PhoneNum
Preparation2023-05-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1KNOXVILLE HOSPITAL & CLINICSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMAGGIE HAMILTON-BEYERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH LINCOLN STREETAddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50138ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$49,566,820GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.KNOXVILLEHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO FAITHFULLY PROVIDE EXCEPTIONAL HEALTHCARE TO THE PEOPLE OF KNOXVILLE & SURROUNDING COMMUNITIES AND TO BE A HEALTHCARE DESTINATION BUILT ON COMPASSION AND INNOVATION.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee336TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$797TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,374,846PYContributionsGrantsAmt
CY Contributions Grants$1,992,747CYContributionsGrantsAmt
PY Program Service Revenue$42,022,393PYProgramServiceRevenueAmt
CY Program Service Revenue$47,261,547CYProgramServiceRevenueAmt
PY Investment Income$83,168PYInvestmentIncomeAmt
CY Investment Income$57,928CYInvestmentIncomeAmt
PY Other Revenue$108,683PYOtherRevenueAmt
CY Other Revenue$226,937CYOtherRevenueAmt
PY Total Revenue$46,589,090PYTotalRevenueAmt
CY Total Revenue$49,539,159CYTotalRevenueAmt
PY Grants And Similar Paid$11,543PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$26,926CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,329,296PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,642,283CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,627,872PYOtherExpensesAmt
CY Other Expenses$25,187,091CYOtherExpensesAmt
PY Total Expenses$40,968,711PYTotalExpensesAmt
CY Total Expenses$44,856,300CYTotalExpensesAmt
PY Revenues Less Expenses$5,620,379PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,682,859CYRevenuesLessExpensesAmt
Total Assets BOY$48,903,473TotalAssetsBOYAmt
Total Assets EOY$49,211,220TotalAssetsEOYAmt
Total Liabilities BOY$25,349,005TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,045,774TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$23,554,468NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$28,165,446NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE ARE DEDICATED TO PROVIDING PERSONAL PROGRESSIVE QUALITY HEALTHCARE WITH COMPASSION TO THE PEOPLE OF KNOXVILLE AND SURROUNDING AREAS. WE VALUE TEAMWORK, INNOVATION, COMPASSION, INTEGRITY, SERVICE, AND PEOPLE-CENTERED CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$40,220,324ExpenseAmt
Grant$26,926GrantAmt
Revenue$47,261,547RevenueAmt
DescKNOXVILLE COMMUNITY HOSPITAL, INC. IS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE BEDS. THE HOSPITAL PROVIDES ACUTE AND ANCILLARY SERVICES TO INDIVIDUALS IN BOTH INPATIENT AND OUTPATIENT SETTINGS. DURING FISCAL YEAR 2022, THE HOSPITAL PROVIDED 568 DAYS OF SKILLED NURSING CARE AND 200,006 OUTPATIENT OCCASIONS OF SERVICE.Desc
Total Program Service Expenses$40,220,324TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document84IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee336EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMAGGIE HAMILTON-BEYERPersonNm
Phone6418421402PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH LINCOLN STREETAddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50138ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
LOGAN MILLER
PHYSICIAN40.000.00Yes (X)$441,528$0$34,974
SAMANTHA KEADY
PHYSICIAN40.000.00Yes (X)$387,036$0$36,856
DYLAN LOWE
PHYSICIAN40.000.00Yes (X)$357,424$0$19,223
JAMES LAW
PHYSICIAN40.000.00Yes (X)$292,261$0$37,945
THOMAS HOEHNS
PHYSICIAN40.000.00Yes (X)$278,638$0$23,899
MAGGIE HAMILTON -BEYER
CFO40.000.00$206,872$0$14,627Yes (X)
JIM BUTLER
PRESIDENT & TREASURER1.000.00$0$0$0Yes (X)Yes (X)
MEGAN MCKAY
PRESIDENT THRU 12/211.000.00$0$0$0Yes (X)Yes (X)
PATRICK STOCKTON
2ND VP & TREASURER THRU 12/211.000.00$0$0$0Yes (X)Yes (X)
CINDI FULLER
SECRETARY1.001.00$0$0$0Yes (X)Yes (X)
TODD CHAMBERS
MEMBER1.000.00$0$0$0Yes (X)
LISA CROSSETT
MEMBER1.000.00$0$0$0Yes (X)
DAVE JOHNSON
MEMBER1.000.00$0$0$0Yes (X)
LORI BAILEY
MEMBER1.000.00$0$0$0Yes (X)
CONNIE CHRISMAN
MEMBER1.000.00$0$0$0Yes (X)
KEVIN KINCAID
CEO40.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,963,759TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$167,524TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CAPITAL ORTHOPEDICS AND SPORTS MEDICINE
12499 UNIVERSITY AVE 210CLIVEIA50325ORTHOPEDIC SURGEONS/DOCTORS$1,560,317
21ST CENTURY REHAB PC
PO BOX 461NEVADAIA50201PT/OT SERVICES$1,520,617
DOCS EMERGENCY MEDICINE INC
800 W FRONTIER LNOLATHEKS66061ER PHYSICIAN COVEREAGE$1,510,252
CERNER CORPORATION
PO BOX 959156ST LOUISMO63195COMPUTER SOFTWARE SYSTEMS$1,414,161
MERCY ONE
1111 6TH AVEDES MOINESIA50314MANAGEMENT CONTRACT$1,063,907
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K32CntrctRcvdGreaterThan100KCnt
Related Organizations$44,272RelatedOrganizationsAmt
Government Grants$1,930,850GovernmentGrantsAmt
All Other Contributions$17,625AllOtherContributionsAmt
Total Contributions$1,992,747TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$24,987,971$24,987,971
MEDICARE621110$15,500,261$15,500,261
MEDICAID621110$4,440,957$4,440,957
PHARMACY621110$2,305,936$2,305,936

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,422TotalRevenueColumnAmt
Related Or Exempt Func Income$26,422RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$47,261,547TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$81,029TotalRevenueColumnAmt
Exclusion$81,029ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$110,772RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$110,772RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$110,772TotalRevenueColumnAmt
Exclusion$110,772ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$4,560OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$27,661OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$23,101OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$23,101TotalRevenueColumnAmt
Exclusion-$23,101ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIADesc
Business900099BusinessCd
Total Revenue Column$116,165TotalRevenueColumnAmt
Unrelated Business Revenue$797UnrelatedBusinessRevenueAmt
Exclusion$115,368ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$116,165OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,539,159TotalRevenueColumnAmt
Related Or Exempt Func Income$47,261,547RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$797UnrelatedBusinessRevenueAmt
Exclusion$284,068ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$26,926TotalAmt
Program Services$26,926ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$221,499TotalAmt
Management And General$221,499ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,698,056TotalAmt
Program Services$13,654,390ProgramServicesAmt
Management And General$2,043,666ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,722,728TotalAmt
Program Services$3,205,848ProgramServicesAmt
Management And General$516,880ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$548,576TotalAmt
Program Services$128,446ProgramServicesAmt
Management And General$420,130ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$24,988TotalAmt
Management And General$24,988ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$99,872TotalAmt
Management And General$99,872ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$11,839TotalAmt
Management And General$11,839ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,603,946TotalAmt
Program Services$7,118,012ProgramServicesAmt
Management And General$485,934ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$76,130TotalAmt
Management And General$76,130ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,275,094TotalAmt
Program Services$2,028,752ProgramServicesAmt
Management And General$246,342ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$89,395TotalAmt
Program Services$76,682ProgramServicesAmt
Management And General$12,713ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,854,279TotalAmt
Program Services$1,639,357ProgramServicesAmt
Management And General$214,922ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$77,846TotalAmt
Program Services$53,398ProgramServicesAmt
Management And General$24,448ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$570,410TotalAmt
Program Services$557,870ProgramServicesAmt
Management And General$12,540ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,608,517TotalAmt
Program Services$1,572,265ProgramServicesAmt
Management And General$36,252ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$276,594TotalAmt
Program Services$209,237ProgramServicesAmt
Management And General$67,357ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$6,280,854$6,280,854
BAD DEBT$3,343,873$3,343,873
DUES & LICENSES$303,144$182,680$120,464
FOOD COST$141,734$141,734

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$44,856,300TotalAmt
Program Services$40,220,324ProgramServicesAmt
Management And General$4,635,976ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$81,673BOYAmt
EOY$83,447EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$26,389,204BOYAmt
EOY$25,484,941EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,510,216BOYAmt
EOY$5,877,902EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$607,788BOYAmt
EOY$575,114EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$251,012BOYAmt
EOY$241,970EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$34,078,006LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$20,451,938LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,092,062BOYAmt
EOY$13,626,068EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,872,964BOYAmt
EOY$3,321,778EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$29,215BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,069,339BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$48,903,473BOYAmt
EOY$49,211,220EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,972,628BOYAmt
EOY$3,055,822EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,880,746BOYAmt
EOY$13,451,774EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,028,564BOYAmt
EOY$826,269EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$150,000BOYAmt
EOY$148,807EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,317,067BOYAmt
EOY$3,563,102EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,349,005BOYAmt
EOY$21,045,774EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$23,554,468BOYAmt
EOY$27,665,446EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
EOY$500,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,554,468BOYAmt
EOY$28,165,446EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$48,903,473BOYAmt
EOY$49,211,220EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$4,682,859ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$71,881NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,533OtherActivitiesAmt
Total Lobbying Expenditures$3,533TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationKNOXVILLE COMMUNITY HOSPITAL, INC. PAYS DUES TO THE IOWA HOSPITAL ASSOCIATION, OF WHICH A PORTION IS USED FOR LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$260,906OtherCostOrOtherBasisAmt
Book Value$260,906BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,023,432OtherCostOrOtherBasisAmt
Depreciation$11,797,834DepreciationAmt
Book Value$10,225,598BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,047,169OtherCostOrOtherBasisAmt
Depreciation$8,654,104DepreciationAmt
Book Value$2,393,065BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$746,499OtherCostOrOtherBasisAmt
Book Value$746,499BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,626,068TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
CAPITAL LEASES$590,307
ACCRUED INTEREST PAYABLE$14,342
CONTRACT LIABILITY - MEDICARE ACCELERATED AND ADVANCE PAYMENTS$2,357,767
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$600,686
FieldValueIRS element (for citing)
Total Liability$3,563,102TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL AND FOUNDATION ACCOUNT FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HOSPITAL AND FOUNDATION RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2022 AND 2021, THE HOSPITAL AND FOUNDATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free Care0FPGReferenceFreeCareInd
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$99,742TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$99,742NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,682,954TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,273,878DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,409,076NetCommunityBenefitExpnsAmt
Total Expense0.03390TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,782,696TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,273,878DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,508,818NetCommunityBenefitExpnsAmt
Total Expense0.03630TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,628TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,725DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,903NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$255,977TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$249,727NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$57,885TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$57,885NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$318,490TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,975DirectOffsettingRevenueAmt
Net Community Benefit Expns$310,515NetCommunityBenefitExpnsAmt
Total Expense0.00750TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,101,186TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,281,853DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,819,333NetCommunityBenefitExpnsAmt
Total Expense0.04380TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$282TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$282NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,380TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,380NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$266TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$266NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,212TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,212NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,597TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,597NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,737TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,737NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$3,343,873BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,062,655ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,949,049CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$113,606MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KNOXVILLE COMMUNITY HOSP INC & CLINICSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 S LINCOLN STREETAddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50138ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.KNOXVILLEHOSPITAL.ORGWebsiteAddressTxt
State License630031HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1KNOXVILLE COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.KNOXVILLEHOSPITAL.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.KNOXVILLEHOSPITAL.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.KNOXVILLEHOSPITAL.ORG/BILLING-INFORMATION-POLICIES/BILLING-PAYMENTSFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.KNOXVILLEHOSPITAL.ORG/BILLING-INFORMATION-POLICIES/BILLING-PAYMENTSFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.KNOXVILLEHOSPITAL.ORG/BILLING-INFORMATION-POLICIES/BILLING-PAYMENTSFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
KNOXVILLE COMMUNITY HOSPITAL, INC.PART V, SECTION B, LINE 3J: THE TOP FOUR HEALTH NEEDS IDENTIFIED FROM THE 2021 CHNA REPORT WERE MENTAL HEALTH, AFFORDABLE HOUSING, TRANSPORTATION AND NUTRITION. THESE TOP FOUR NEEDS WERE DETERMINED BY PRIMARY DATA (SURVEY) AND SECONDARY DATA INCLUDING COUNTY HEALTH RANKINGS, IOWA HOSPITAL ASSOCIATION INPATIENT AND OUTPATIENT DATABASES, CITY DATA, AND VITAL STATISTICS. OTHER HEALTH NEEDS IDENTIFIED WERE OBESITY, SUBSTANCE MISUSE, DOMESTIC ABUSE, SUICIDE PREVENTION AND SUPPORT AND POVERTY.
KNOXVILLE COMMUNITY HOSPITAL, INC.PART V, SECTION B, LINE 5: RESEARCH WAS DONE AND DATA WAS COLLECTED TO ENSURE PROPER TOWN HALL REPRESENTATION AND TO DETERMINE THE PRIMARY SERVICE AREA. A PUBLIC RELATIONS STORY WAS PREPARED AND POSTED ON SOCIAL MEDIA, AS WELL AS SENT TO THE LOCAL MEDIA TO PUBLISH AND ANNOUNCE UPCOMING CHNA WORK AND REQUEST PUBLIC SURVEY PARTICIPATION. A PAPER SURVEY AS WELL AS AN ONLINE LINK TO THE SURVEY WAS MADE AVAILABLE FOR THE PUBLIC TO RESPOND. KHC STAFF ALSO VISITED WITH MANY LOCAL GROUPS SUCH AS ROTARY ABOUT THE CHNA PROCESS AND REQUESTED COMPLETION OF SURVEYS FOR THOSE PRESENT AT THAT MEETING. A PAPER SURVEY WAS USED WITH AN ONLINE LINK TO PSA RESIDENTS. THE SURVEY WAS SENT TO 1,000 PARTICIPANTS WITH THE ANTICIPATION OF RECEIVING 250 RETURNS. WE PREPARED AND PUBLISHED A TOWN HALL INVITATION TO THE PUBLIC AND COLLABORATING PARTIES SUCH AS PUBLIC HEALTH, SCHOOL LEADERS, FAITH-BASED LEADERS, PHYSICIANS AND OTHER CARE PROVIDERS, AS WELL AS THE MENTAL HEALTH PROVIDER COMMUNITY, FREE CLINICS, LOCAL RESIDENTS, COMMUNITY LEADER, BUSINESS LEADERS, LOCAL GOVERNMENT, PEOPLE WITH CHRONIC CONDITIONS, AND UNINSURED COMMUNITY MEMBERS, LOW INCOME RESIDENTS, AND MINORITY GROUPS ALONG WITH KNOXVILLE HOSPITAL & CLINICS. WE PREPARED A BRIEF OF GOALS, OBJECTIVE, PURPOSE, OUTCOMES, ROLES, AND COMMUNITY INVOLVEMENT AND HELD A KICK-OFF MEETING. COMMUNITY HEALTH FACTS AND PRACTICE DATA WERE COLLECTED AND PUBLISHED. COMMUNITY OPINIONS WERE COLLECTED ON HEALTH NEEDS, AND NEEDS IDENTIFIED. COMMUNITY OPINIONS WERE ALSO COLLECTED ON HEALTH NEEDS, PRACTICES, AND PHYSICIAN AND CARE PROVIDER AVAILABILITY. THE COMMUNITY HEALTH NEEDS REPORT WAS THEN PREPARED AND PRESENTED TO THE COMMUNITY WITH RECOMMENDED ACTIONS. THE TOWN HALL MEETING INCLUDED DISCUSSION ON PURPOSE, ROLES, REVIEW OF HISTORICAL DATA, PARTICIPANT DISCUSSIONS TALLY AND RANKING OF HEALTH CONCERNS, AND REFLECTION ON THE HEALTH NEEDS OF THE COMMUNITY. THE MEETING CONCLUDED WITH INFORMATION ABOUT THE NEXT STEPS. THE COMMUNITY WAS ENCOURAGED TO CONTINUE TO PARTICIPATE BY CONTRIBUTING IDEAS TO THE HOSPITAL AND PUBLIC HEALTH DEPARTMENT VIA EMAIL OR PERSONAL CONVERSATION. IN ADDITION, OTHER MEETINGS, INTERVIEWS, AND FOCUS GROUPS WERE HELD.
KNOXVILLE COMMUNITY HOSPITAL, INC.PART V, SECTION B, LINE 11: 1. MENTAL HEALTH INCREASE THE PROVIDED AND BREATH OF SERVICES FOR MENTAL HEALTH NEEDS IN THE COMMUNITIES.A. SINCE NOVEMBER OF 2019, MOST OF THESE EFFORTS HAVE BEEN CONCENTRATED ON STATEWIDE AND COUNTYWIDE INITIATIVES. MOST HOURS WERE SPENT IN COLLABORATION WITH THE MARION COUNTY SHERIFF'S OFFICE AND THE LEADERS OF THE COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA ACCESS CENTER LOCATED IN OSCEOLA, IA. THE ACCESS CENTER WAS CREATED IN THIS REGION OF IOWA AND IN OTHER REGIONS AROUND THE STATE. REFERRALS ARE MADE TO THE ACCESS CENTER FOR PATIENTS EXPERIENCING A MENTAL HEALTH CRISIS. THE ACCESS CENTER HAS PROVIDED SOME RELIEF FOR AREA HOSPITALS BUT, FOR SEVERAL REASONS, SOME MENTAL HEALTH PATIENTS DO NOT QUALIFY FOR THESE SERVICES OR REQUIRE INTENSIVE INPATIENT PSYCHIATRIC CARE, SO KHC CONTINUES TO HOLD SOME MENTAL HEALTH PATIENTS IN THE EMERGENCY ROOM FOR A SIGNIFICANT NUMBER OF DAYS.B. KHC CONTINUES TO UTILIZE VIRTUAL VISITS TO ADDRESS (NON-CRISIS) MENTAL HEALTH CONCERNS FOR PATIENTS IDENTIFIED VIA AN ANNUAL DEPRESSION SCREEN AT THE MEDICAL CLINICS. CLINIC PROVIDER TIMELY ASSESSMENTS TO IDENTIFY ISSUES AND INTERVENTIONS INCLUDING A REFERRAL TO VARIOUS RESOURCES ASSIST IN THE PREVENTION OF A CRISIS. ALSO, THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT CONTINUES TO UTILIZE TELE-PSYCH TO IMPROVE ACCESS TO MENTAL HEALTH PROVIDERS IN THE EMERGENCY DEPARTMENT. THE TELE-PSYCH SYSTEM IS UTILIZED FOR ALMOST ALL OUTPATIENT MENTAL HEALTH PATIENTS THAT PRESENT TO THE EMERGENCY ROOM. ALSO, KHC HAS AN AGREEMENT WITH CENTRAL IOWA JUVENILE DETENTION CENTER WHICH PROVIDES TRANSPORT FOR MEDICALLY STABLE PATIENTS IN A SECURE CAR. THIS SERVICE IS NECESSARY BECAUSE OF THE LIMITED AVAILABILITY OF LOCAL EMS CREWS TO TRANSPORT THESE PATIENTS.C. KEVIN KINCAID CONTINUES TO LOBBY FOR IMPROVEMENTS IN INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES FOR MEMBERS OF THE COMMUNITY. IN FEBRUARY OF 2021 A NEW 100 BED MENTAL HEALTH HOSPITAL WILL OPEN IN CLIVE, IOWA THROUGH A PARTNERSHIP BETWEEN MERCYONE AND UHS IN CLIVE, IOWA. KNOXVILLE HOSPITAL & CLINICS AS AN AFFILIATE OF MERCYONE MAY BENEFIT WITH A FASTER REFERRAL PROCESS TO THIS ORGANIZATION FOR MEMBERS OF THE COMMUNITY IN NEED OF INPATIENT MENTAL HEALTH SERVICES.2. SUBSTANCE ABUSE REDUCE THE CONCERN FOR AND PRESENCE OF SUBSTANCE ABUSE RELATED HEALTH/SAFETY ISSUES.A. KNOXVILLE HOSPITAL & CLINICS APPLIED AND RECEIVED THE RURAL COMMUNITIES OPIOID RESPONSE PROGRAM (RCORP) THIS IS A MULTI-YEAR HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) INITIATIVE AIMED AT REDUCING THE MORBIDITY AND MORTALITY OF SUBSTANCE USE DISORDER (SUD), INCLUDING OPIOID USE DISORDER (OUD) IN HIGH-RISK RURAL COMMUNITIES. THE GRANT IS A COLLABORATION OF MULTIPLE COMMUNITY GROUPS IN MARION COUNTY INCLUDING MARION COUNTY PUBLIC HEALTH, THE WELL RESOURCE CENTER, UCS HEALTHCARE, CROSS MENTAL HEALTH REGION, KNOXVILLE COMMUNITY SCHOOL DISTRICT, PELLA REGIONAL HEALTH CENTER AND KNOXVILLE HOSPITAL & CLINICS. INITIATIVES HAVE INCLUDED PROVIDING EDUCATION, PARTICIPATION IN NATIONAL TAKE BACK DAY, PROVIDING SAFE MEDICATION DISPOSAL BAGS FOR FREE TO PATIENTS, AND COLLABORATING WITH OTHER ENTITIES TO ADVANCE THE GOALS OF THE PROGRAM. THE WORK WILL CONTINUE THROUGH 2024. B. KNOXVILLE PROVIDERS HAVE AND WILL CONTINUE TO REFER PATIENTS TO UCS AS NEEDED. PROVIDERS HAVE MATERIALS REGARDING UCS AND THOSE MATERIALS ARE SHARED WITH PATIENTS AS NEEDED. ALSO, OTHER COMMUNITY PARTNERS SUCH AS THE WELL, LAW ENFORCEMENT, AND SCHOOLS ARE AWARE OF THE SERVICES UCS PROVIDERS AND PASS THAT INFORMATION ON TO PEOPLE IN NEED OF THE SERVICES.C. KHC CONTINUES TO PARTNER WITH UCS, DHS, LAW ENFORCEMENT, AND MC3 TO EXPLORE TRANSPORTATION SERVICES WITHIN THE COMMUNITY. THE HIRTA SYSTEM IS STILL AVAILABLE IN MARION COUNTY BUT, SERVICES CONTINUE TO BE QUITE LIMITED.3. CHRONIC DISEASE MANAGEMENT REDUCE IMPACT OF CHRONIC DISEASE ON PHYSICAL AND MENTAL HEALTH FOR RESIDENTS IN THE COMMUNITIES.A. KNOXVILLE HOSPITAL & CLINICS LAUNCHED #HEALTHYKNOXVILLE, A MONTHLY COMMUNITY WELLNESS CHALLENGE DESIGNED TO INSPIRE COMMUNITY MEMBERS TO LIVE A HEALTHIER LIFESTYLE PHYSICALLY, MENTALLY, EMOTIONALLY, SPIRITUALLY, INTELLECTUALLY, AND FINANCIALLY. KNOXVILLE HOSPITAL & CLINICS TOGETHER WITH OUR PARTNERS THE KNOXVILLE WELLNESS COALITION, KNOXVILLE COMMUNITY SCHOOL DISTRICT, KNOXVILLE CHAMBER OF COMMERCE, AND THE CITY OF KNOXVILLE PROVIDE FUN CHALLENGES TO HELP INDIVIDUALS ASPIRE TO BE THE BEST VERSION OF THEMSELVES. THE PROGRAM AVERAGES ABOUT 15 PARTICIPANTS EACH MONTH. KNOXVILLE HOSPITAL & CLINICS LEADERS ARE WORKING WITH THE SCHOOLS TO ENCOURAGE ELEMENTARY TEACHERS TO DO IT AS A CLASS ACTIVITY AS WELL.B. IN LATE 2018 KNOXVILLE HOSPITAL & CLINICS AND 21ST CENTURY REHABILITATION SERVICES OPENED A MEDICALLY ORIENTED GYM (MOG). A MOG IS A REVOLUTIONIZING THE WAY PEOPLE IMPROVE AND MAINTAIN THEIR HEALTH. THE MOG IS STAFFED BY PHYSICAL THERAPISTS, PHYSICAL THERAPIST ASSISTANTS, AND CERTIFIED ATHLETIC TRAINERS WHO WORK CLOSELY WITH YOUR DOCTOR AND OTHER HEALTHCARE PROVIDERS TO HELP YOU ACHIEVE AND MAINTAIN AN EXCEPTIONAL QUALITY OF LIFE BY FOCUSING ON ALL ASPECTS OF YOUR HEALTH. THE PRIMARY GOAL OF THE MOG IS TO DECREASE DEPENDENCY ON MEDICINE, ADOPT EXERCISE AS A LIFESTYLE, AND REDUCE THE IMPACTS OF CHRONIC DISEASE. MOG ON AVERAGE CARES FOR BETWEEN 25 TO 35 MEMBERS A MONTH WHICH IS AN INCREASE OF ABOUT 10 MEMBERS PER MONTH OVER THE LAST YEAR. C. KHC HAS CONTINUED TO REACH OUT TO PATIENTS/COMMUNITY MEMBERS WITH DIETARY COUNSELING NEEDS THROUGH OUR INTENSIVE BEHAVIOR THERAPY FOR OBESITY. FOLLOWING OUR PATIENT-CENTERED MEDICAL HOME MODEL, PROVIDERS SEND REFERRALS TO NUTRITION SERVICES, WHERE OUR STAFF OF TWO LICENSED AND REGISTERED DIETITIANS (RDS) PROVIDE AN INDIVIDUALIZED AND EVIDENCED-BASED WEIGHT MANAGEMENT PROGRAM. CHANGING BEHAVIORS TAKES TIME AND THE JOURNEY IS DIFFERENT FOR EVERYONE, WHICH THIS SERVICE ADDRESSES BY MEETING THE PARTICIPANT WHERE HE/SHE IS AT, AND THEN COLLABORATIVELY, WITH THE RD UTILIZING MOTIVATIONAL INTERVIEWING, SHE AND THE PATIENT IDENTIFY SMART GOAL(S) TO WORK TOWARDS. FOR PATIENTS NOT INTERESTED IN A 'IBT-LIKE' PROGRAM, OUR RDS COLLABORATE WITH OUR HEALTH COACH (A REGISTERED NURSE) TO DETERMINE THE BEST PATH FORWARD. KHC DIETITIANS CONTINUE TO WORK WITH PATIENTS/COMMUNITY MEMBERS WITH DIETARY COUNSELING NEEDS FOR VARIOUS CHRONIC DISEASE STATES THROUGH NUTRITION MANAGEMENT. ALSO, DIABETES SUPPORT GROUPS HAVE RESTARTED WHICH ENCOURAGE ATTENDANCE FROM CURRENT PATIENTS AS WELL AS COMMUNITY MEMBERS. DAY AND EVENING OPTIONS ARE AVAILABLE TO REACH A WIDER RANGE OF INDIVIDUALS. TOPICS RANGE FROM DIABETES-FRIENDLY COOKING DEMONSTRATIONS, CURRENT ADVANCES IN DIABETES TECHNOLOGY, AND PRESENTATIONS FROM LOCAL SPECIALISTS IN DIABETES-RELATED AREAS.UPON REQUEST, KHC DIETITIANS' PARTNER WITH THE LOCAL HIGH SCHOOL TO PROVIDE NUTRITION EDUCATION TO ATHLETES AND STUDENTS. D. CARDIOPULMONARY REHAB HAS PARTICIPATED IN COMMUNITY HEALTH INITIATIVES AS A PREVENTION MEASURE OF HEART AND LUNG DISEASE. THIS PAST YEAR THE OPPORTUNITY OCCURRED WITH WOMEN'S HEALTH INITIATIVE OFFERED OCTOBER 6, 2022. IN ADDITION, THE CARDIOPULMONARY REHAB PROGRAM CONTINUES TO OFFER FREE SMOKING CESSATION EDUCATION TO ANYONE IN THE COMMUNITY THAT NEEDS SUPPORT. 4. TRANSPORTATION MAKE ACCESSIBLE (EASY) FOR INDIVIDUALS TO USE WITH REASONABLE ACCESS & AFFORDABILITY.A. KHC HAS UTILIZED HOME INSTEAD FOR PRIVATE-PAY CARE AND TRANSPORTATION FOR INDIVIDUALS UNDERGOING ANESTHESIA FOR PROCEDURES AT KHC. KNOXVILLE CURRENTLY HAS TWO TAXI SERVICES IN KNOXVILLE: STANTON TAXI AND LYDIA'S TAXI THAT HAVE BEEN UTILIZED TO TRANSPORT PATIENTS IN NEED. ALSO, EVERY STEP SENIOR COMPANION PROGRAM AND HIRTA PSVP PARTNER WITH INDIVIDUAL VOLUNTEERS WHO ARE TO PROVIDE TRANSPORTATION AS WELL AS COMPANIONSHIP AND LIGHT HOUSEKEEPING.B. KHC IS EXPLORING THE UTILIZATION OF UBER/HEALTHCARE AS AN OPTION FOR PATIENT TRANSPORTATION IN THE COMMUNITY. C. KHC IS DEVELOPING A PLAN TO PROVIDE TRANSPORTATION TO PATIENTS IN NEED TO ENSURE THEY MAKE APPOINTMENTS FOR DOCTOR VISITS AND NECESSARY PROCEDURES. FOCUS ON PATIENTS WITH THE GREATEST NEED IN THE COMMUNITY. ALSO, EXPLORING AN ORGANIZED VOLUNTEER SYSTEM THAT WOULD MINIMIZE PHONE CALLS AND PROVIDE AN OPPORTUNITY FOR VOLUNTEERS TO BE EASILY CONNECTED WITH SERVICES OPPORTUNITIES, INCLUDING ONE-TIME NEEDS.
KNOXVILLE COMMUNITY HOSPITAL, INC.PART V, SECTION B, LINE 13H: THE HOSPITAL CONSIDERED FAMILY SIZE IN ADDITION TO THE CRITERIA ABOVE.
KNOXVILLE COMMUNITY HOSPITAL, INC.PART V, SECTION B, LINE 15E: A LETTER IS SENT PRIOR TO COLLECTION DETAILING THE PAYMENT PLANS AND FINANCIAL ASSISTANCE AVAILABLE TO THOSE WHO QUALIFY.
KNOXVILLE COMMUNITY HOSPITAL, INC.PART V, SECTION B, LINE 16J: A LETTER IS SENT, AND IN MANY CASES TWO, PRIOR TO COLLECTION DETAILING THE PAYMENT PLANS AND FINANCIAL ASSISTANCE AVAILABLE TO THOSE WHO QUALIFY.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - KNOXVILLE AREA COMMUNITY HOSPITAL CLINIC
1202 WEST HOWARD STREETKNOXVILLEIA50138PHYSICIAN CLINIC
2 - MELCHER PHYSICIANS CLINIC
113 NORTH MAIN STREETMELCHERIA50163PHYSICIAN CLINIC
3 - PLEASANTVILLE PHYSICIAN CLINIC
104 NORTH WASHINGTON STREETPLEASANTVILLEIA50225PHYSICIAN CLINIC
4 - RED ROCK HEALTH CENTER
615 WASHINGTON STREETPELLAIA50219PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE OR DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.
PART I, LINE 6A:THE COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED PARTY.
PART I, LINE 7:THE COST TO CHARGE RATIO AS FOLLOWS WAS USED TO DETERMINE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS AT COST: (TOTAL EXPENSES - BAD DEBT) / (GROSS PATIENT SERVICE REVENUE + OTHER REVENUE) = PERCENTAGE OF COST TO CHARGE. OTHER COMMUNITY BENEFIT EXPENSES ARE STATED AT COST BASED ON KNOXVILLE COMMUNITY HOSPITAL INC.'S INTERNAL ACCOUNTING RECORDS.
PART I, LINE 7G:THERE ARE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G.
PART I, LN 7 COL(F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,343,873.
PART II, COMMUNITY BUILDING ACTIVITIES:COMMUNITY SERVICE: THE HOSPITAL PROVIDES MEETING ROOM SPACE TO A NUMBER OF COMMUNITY ORGANIZATIONS AT NO COST. THE HOSPITAL PROVIDES SUPPORT TO THE LOCAL CHAMBER WITH MONETARY AND TIME DONATIONS. A FIRST AID TENT INCLUDING LABOR AND SUPPLIES FOR MEDICAL TREATMENT IS PROVIDED DURING KNOXVILLE NATIONALS AND CHAMBER EVENTS. THE HOSPITAL HOSTS AN ANGEL TREE EVERY YEAR TO HELP FAMILIES IN NEED AT CHRISTMAS. WE SUPPORT THE ANNUAL CHRISTMAS LIGHT SHOW AT MARION COUNTY PARK. THE PROCEEDS GO TO THE LOCAL HISTORICAL SOCIETY. THE HOSPITAL OFFERS HEALTH FAIRS ANNUALLY TO MEN, WOMEN AND CHILDREN. THE HOSPITAL MAINTAINS A STRONG RELATIONSHIP WITH THE LOCAL SCHOOL SYSTEM, PROVIDING ATHLETIC TRAINING CARE AT EVENTS AND FREE SPORT PHYSICALS. WE HELD A BREAST CANCER SUPPORT EVENT ON THE SQUARE WITH HEALTH INFORMATION VENDORS.ECONOMIC DEVELOPMENT: THE HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT TRAINING QUARTERLY TO DEPARTMENT LEADERS. ROTATIONS AND PRECEPTORSHIPS ARE MADE AVAILABLE IN VARIOUS SPECIALTIES FOR STUDENTS GOING INTO THE MEDICAL FIELD. THE HOSPITAL IS A MEMBER OF THE LOCAL CHAMBER AND ROTARY CLUB, WITH EMPLOYEES PARTICIPATING IN BOTH. THE HOSPITAL'S ADMISSIONS DIRECTOR IS ON THE LOCAL DAY CARE BOARD. THE HOSPITAL DONATES TO LOCAL PROJECTS ON A REGULAR BASIS. THE HOSPITAL HAS EMPLOYEES ATTENDING CAREER FAIRS IN THE AREA, AND IS PART OF THE LOCAL THRIVE PROGRAM.COMMUNITY SUPPORT: MONETARY AND IN-KIND DONATIONS ARE GIVEN TO MANY COMMUNITY ORGANIZATIONS AND SCHOOL GROUPS. THE HOSPITAL SUPPORTS CANCER FUND RAISERS, PROM SAFETY EVENTS, SPORTING TEAMS, AND OTHER EVENTS. THE HOSPITAL PARTICIPATES IN LOCAL PARADES AND STRONGLY SUPPORTS LOCAL CHAMBER EVENTS AS WELL AS THE THRIVE PROGRAM. HOSPITAL EMPLOYEES SERVE ON LOCAL COMMUNITY BOARDS; SPEAK AT SCHOOL HEALTH AND CAREER EVENTS; TEACH SUNDAY SCHOOL; PROVIDE COACHING FOR AREA SPORTS TEAMS; AND DONATE TIME TO HABITAT FOR HUMANITY, 4H CLUBS, AND THE HISTORICAL SOCIETY. THE HOSPITAL OFFERED A WELCOME TO MEDICARE CLASS. THE HOSPITAL DONATES TO THE LOCAL THRIVE ORGANIZATION.ECONOMIC IMPROVEMENTS: THE HOSPITAL AGGRESSIVELY RECRUITS FOR NEW PROVIDERS IN AN EFFORT TO SUSTAIN AND GROW. THE HOSPITAL IS PLANNING AN EXTENSIVE REMODEL TO EXPAND ITS EMERGENCY ROOM AND SURGERY AREA. THE HOSPITAL CONTINUOUSLY LOOKS FOR NEW WAYS TO IMPROVE THE HEALTH OFFERINGS PROVIDED TO THE COMMUNITY. THE HOSPITAL HAS EXPANDED COMMUNITY INVOLVEMENT IN IMPROVEMENT AND EXPANSION OF HOSPITAL SPACES. THE HOSPITAL HAS A RELATIONSHIP WITH AREA SCHOOLS, OFFERING FREE SPORTS PHYSICALS. THE HOSPITAL IS CURRENTLY WORKING ON PLANS FOR A NEW PROVIDER CLINIC AND RELOCATION OF CONTRACTED SPECIALISTS TO A BIGGER SPACE AS WELL AS A NEW INFUSION CENTER.COALITION BUILDING: THE HOSPITAL PROVIDES STAFF MEMBERS FOR THE MARION COUNTY HEALTH COALITION TEAM, WHICH INCLUDES A NUMBER OF NURSES EMPLOYED BY THE HOSPITAL. OUR ER COORDINATOR IS INVOLVED IN SERVICE AREA COALITION AND IS ON THE REGIONAL MASS CASUALTY TASK FORCE. HOSPITAL EMPLOYEES WORK WITH THE LOCAL PUBLIC HEALTH DEPARTMENT. THE HOSPITAL ALSO PERFORMS THE COMMUNITY HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENT AND MAINTAINS A PRESENCE IN THE COMMUNITY MENTAL HEALTH TEAM. THE HOSPITAL, IN CONJUNCTION WITH OTHER LOCAL AGENCIES, MAINTAINS A SUICIDE PREVENTION TASK FORCE. THE HOSPITAL PARTICIPATES IN AND SUPPORTS THE LOCAL BACK TO SCHOOL EVENTS. EMPLOYEES SERVE ON A LOCAL DAY CARE BOARD.COMMUNITY HEALTH IMPROVEMENT: THE HOSPITAL IS DESIGNATED AS A PATIENT CENTERED MEDICAL HOME BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. THE HOSPITAL HOSTS, PARTICIPATES IN, OR PROVIDES SUPPORT FOR A VARIETY OF COMMUNITY PROGRAMS AND EVENTS INCLUDING PICK A BETTER SNACK SCHOOL PROGRAM, LOCAL HEALTH FAIRS, GIRLS NIGHT OUT, LOVE YOUR HEART DAY, SPORTS PHYSICALS, SPORTING EVENTS, DIABETES EDUCATION, CPR AND BLS CLASSES, FLU SHOT CLINICS, AND MORE. OUR PHYSICAL THERAPY DEPARTMENT OFFERS A VARIETY OF CLASSES ON PATIENTS PHYSICAL HEALTH IMPROVEMENT. PHYSICIANS PARTICIPATE IN LOCAL HEALTH BOARDS AND CONSULT FREE OF CHARGE TO THE OTHER ORGANIZATIONS. THE HOSPITAL HAS ACUTE CARE FROM 7AM TO 7PM FOR QUICKER ACCESS FOR PATIENTS WHO DON'T HAVE APPOINTMENTS. THE HOSPITAL CEO IS NOW ON OTHER ORGANIZATIONS' BOARDS, AND CONTINUES TO WORK ON A PLAN TO IMPROVE ACCESS TO MENTAL HEALTH CARE TO PATIENTS IN OUR AREA. THE HOSPITAL OFFERS VIRTUAL CARE VISITS. THE HOSPITAL SURVEYS ITS PATIENTS REGULARLY AND USES THE DATA TO IMPROVE CARE. IN 2021, THE HOSPITAL CREATED A PERMANENT COVID CLINIC SPACE AND IS IN THE PLANNING STAGES FOR A TRAVELING MOBILE CLINIC.OTHER: THE HOSPITAL PROVIDES CAB FARE FROM THE EMERGENCY ROOM FOR INDIGENTS AND USE OF OUR ROOMS FOR LOCAL CLUBS AND COMMUNITY MEETINGS. ADMINISTRATIVE ASSISTANCE IS OFFERED TO VARIOUS ORGANIZATIONS. ONE OF OUR DOCTORS IS PRESIDENT OF THE IOWA PHYSICIANS SOCIETY AND PHYSICIAN CHAMPION FOR THE ACO HEALTH GRANT. THE HOSPITAL NOW OFFERS TELEHEALTH TO HELP PROVIDE ACCESS TO MENTAL HEALTH PROFESSIONALS TO OUR AREA PATIENTS, AND WE PAY FOR PATIENT TRANSPORTATION TO FACILITIES THAT CAN PROVIDE MENTAL HEALTH SERVICES WE DO NOT PROVIDE.
PART III, LINE 2:THE HOSPITAL DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR GOODS AND SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE HOSPITAL'S POLICY, AND OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED PATIENTS. THE HOSPITAL DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. THE HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS.
PART III, LINE 3:THE HOSPITAL PROVIDES PATIENT FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE HOSPITAL DETERMINES THE COSTS ASSOCIATED WITH PROVIDING PATIENT FINANCIAL ASSISTANCE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES AND OTHER OPERATING EXPENSES, BASED ON THE OVERALL COST TO CHARGE RATIO FOR THE HOSPITAL. THE COSTS OF CARING FOR PATIENTS WHO QUALIFY UNDER THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE POLICY FOR THE YEAR ENDED JUNE 30, 2022 WERE $205,000.
PART III, LINE 4:THE HOSPITAL'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 8, 11 AND 12 OF THE ATTACHED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES" "PATIENT SERVICE REVENUE AND "PATIENT FINANCIAL ASSISTANCE".
PART III, LINE 8:THERE IS NO SHORTFALL REPORTED DURING THE YEAR, THEREFORE NO AMOUNT IS TREATED AS A COMMUNITY BENEFIT. "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT D & E WORKSHEETS, OR PS&R.
PART III, LINE 9B:THE CHARITY CARE POLICY ALLOWS FOR PROACTIVE WRITE OFF TO ALLOWANCE FOR CHARITY CARE OF ANY BALANCE OWED BY A PATIENT KNOWN TO QUALIFY FOR CHARITY CARE UNDER THE FINANCIAL ASSISTANCE POLICY. COLLECTION PROCEDURES DO NOT ENSUE ON ANY ACCOUNTS ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2:DURING TAX YEAR 2021, KNOXVILLE COMMUNITY HOSPITAL, INC. AND CLINICS, IN COLLABORATION WITH MARION COUNTY PUBLIC HEALTH, HELD TOWN HALL MEETINGS BY SENDING OUT SURVEYS TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT TO SET HEALTH GOALS AND PROGRAMS TO ADDRESS THE HEALTH NEEDS AND DESIRES OF THE COMMUNITY CAPTURED IN THE HOSPITAL'S ANNUAL COMMUNITY BENEFIT REPORT. ALSO, THE HOSPITAL ALWAYS UTILIZES INPUT FROM MEDICAL STAFF, THE BOARD OF DIRECTORS AND VARIOUS HOSPITAL ADMINISTRATIVE STAFF WHO REGULARLY REVIEW THE TREATMENT OF PATIENTS TO ENSURE MEDICAL NECESSITY AND APPROPRIATE LEVELS OF CARE ARE CONSISTENTLY PROVIDED TO THE PATIENTS OF THE HOSPITAL.
PART VI, LINE 3:CUSTOMER SERVICE AND BILLING STAFF CONTINUALLY MONITOR BALANCES WITHOUT ACTIVITY AND THEN CONTACT THE PATIENTS TO OFFER FINANCIAL ASSISTANCE OR ARRANGE PAYMENT PLANS. THE HOSPITAL ALSO OFFERS THE ABILITY TO MAKE PAYMENTS VIA A WEB-BASED PORTAL. THE PORTAL CONTAINS INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE AND PAYMENT PLAN POLICIES.
PART VI, LINE 4:THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING CITIES IN MARION COUNTY: KNOXVILLE (POP. 11,583), PLEASANTVILLE (POP. 2,954), AND MELCHER/DALLAS (POP. 1,625). THE KNOXVILLE COMMUNITY IS 40 MILES SOUTHEAST OF DES MOINES, IOWA.
PART VI, LINE 5:KNOXVILLE COMMUNITY HOSPITAL, INC. AND THE CLINICS PROVIDE NUMEROUS OUTPATIENT SPECIALTY PROVIDER CLINICS SUCH AS PODIATRY, ORTHOPEDICS, CARDIOLOGY, UROLOGY, DERMATOLOGY, SLEEP STUDY, ONCOLOGY, AUDIOLOGY, NEPHROLOGY, RHEUMATOLOGY AND EMG TESTING AND OBGYN. PROVIDERS AND STAFF PROVIDE VARIOUS FREE EDUCATIONAL/WELLNESS PROGRAMS FOR THE COMMUNITY/SCHOOLS. THE HOSPITAL IS ADDING TO ITS SPECIALTIES YEARLY, HOSTING ANNUAL PUBLIC EVENTS INCLUDING FREE SKIN CANCER SCREENING. THESE ARE PUBLISHED IN LOCAL NEWSPAPERS.
PART VI, LINE 6:DURING TAX YEAR 2021, KNOXVILLE COMMUNITY HOSPITAL, INC. AND CLINICS WERE AFFILIATED MEMBERS OF THE MERCY HEALTH NETWORK - CENTRAL IOWA THROUGH MERCY HOSPITAL - DES MOINES, IOWA. MERCY HEALTH NETWORK - CENTRAL IOWA INCLUDES 17 CAH/TWEENER HOSPITALS ALL LOCATED IN CENTRAL IOWA. BENEFITS OF THE AFFILIATION ARE NUMEROUS AND INCLUDE: A. SHARING OF BEST PRACTICES B. SAVINGS ON GROUP PURCHASING AGREEMENTS C. SAVINGS THROUGH GROUP CONTRACTING FOR NUMEROUS SERVICES D. ACCESS TO NUMEROUS HEALTH CARE EXPERTS E. ACCESS TO PROVIDERS OF ALL TYPES AND SPECIALTIES F. ACCESS TO COMPARATIVE REPORTING G. SUPPORT FOR HUMAN RESOURCES, MEDICAL CLINICS, PURCHASING, FINANCE, NUTRITION, MEDICAL SURGERY, AND ANCILLARY AREAS.
PART VI, LINE 7, REPORTS FILED WITH STATESIA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LOGAN MILLER
PHYSICIAN$403,709$0$35,694$0$2,125$0$8,550$0$26,424$0$476,502$0$0$0
SAMANTHA KEADY
PHYSICIAN$385,274$0$0$0$1,762$0$10,913$0$25,943$0$423,892$0$0$0
DYLAN LOWE
PHYSICIAN$340,214$0$15,000$0$2,210$0$10,134$0$9,089$0$376,647$0$0$0
JAMES LAW
PHYSICIAN$280,380$0$9,756$0$2,125$0$8,700$0$29,245$0$330,206$0$0$0
THOMAS HOEHNS
PHYSICIAN$276,513$0$0$0$2,125$0$5,485$0$18,414$0$302,537$0$0$0
MAGGIE HAMILTON -BEYER
CFO$197,372$0$9,500$0$0$0$5,183$0$9,444$0$221,499$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART II:FormAndLineReferenceDesc
ExplanationKEVIN KINCAID, CEO, WAS PAID BY AN UNRELATED ORGANIZATION, MERCYONE MEDICAL CENTER - DES MOINES. MERCYONE MEDICAL CENTER HAS A MANAGEMENT AGREEMENT WITH KNOXVILLE COMMUNITY HOSPITAL INC. KNOXVILLE COMMUNITY HOSPITAL PAYS MERCYONE MEDICAL CENTER FOR THE COMPENSATION OF THE CEO/ADMINISTRATOR. THE AMOUNT OF COMPENSATION PAID BY MERCYONE MEDICAL CENTER TO KEVIN KINCAID FOR HIS SERVICES AS CEO TO KNOXVILLE COMMUNITY HOSPITAL WAS $329,596 MERCYONE MEDICAL CENTER IS PART OF CATHOLIC HEALTH INITIATIVES.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF KNOXVILLE IOWA
A4260048432014-09-20$8,650,000REFINANCE INDEBTEDNESS INCURRED TO RENOVATE FACILITIES AND PURCHASE EQUIP.000
MARION COUNTY IOWA
B4211825282014-09-20$8,650,000FINANCE RENOVATION OF FACILITIES AND PURCHASE EQUIP.000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndUnspentUnspentAmt
A$1,396,104$8,650,000$128,143$6,527,480$1,994,3772016Yes (1)0Yes (1)Yes (1)
B$704,758$8,650,000$128,143$7,161,857201600Yes (1)Yes (1)$1,360,000

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.0000000Yes (1)
B00000.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0000Yes (1)000Yes (1)
B0000Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART II, COLUMN A, LINE 11:$1,994,377 FOR OTHER PROCEEDS WERE SPENT TO REFUND THE 2012 BONDS THAT WERE CALLED ON AUGUST 20, 2014.
SCHEDULE K, PART II, COLUMN B, LINE 12:$1,360,000 OF THE BOND ISSUE PRICE WAS NEVER DRAWN UPON AND THERE WILL NEVER BE ANY MONEY BORROWED UPON OR SPENT FROM THIS AMOUNT.
SCHEDULE K, PART II, COLUMNS A AND B, LINE 13:THE PROJECT WAS DONE AS A PHASE IN PROJECT WITH MULTIPLE AREAS RENOVATED AND NEW AREAS BUILT. THE ENTIRE PROJECT WAS CONSIDERED COMPLETED BY JUNE 3, 2016.
SCHEDULE K, PART III, COLUMNS A AND B, LINE 4:IN 2022, NONE OF THE NEW CLINIC SPACE WAS LEASED. ALL OF THE LEASED SPACE BY SPECIALTY DOCTORS HAS BEEN CONVERTED TO CONTRACT PROVIDER AGREEMENTS OR MOVED TO A NON-BOND FINANCED AREA. THE HOSPITAL HAD ALL OF THE CONTRACT PROVIDER AGREEMENTS REVIEWED BY LEGAL COUNSEL TO ENSURE THAT THE CONTRACTS MEET THE SAFE HARBOR REQUIREMENTS FOR SERVICE AND MANAGEMENT CONTRACTS, THEREBY RESULTING IN NO PRIVATE USE IN THE NEW CLINIC.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE, COMPRISED OF THE PRESIDENT, FIRST VICE PRESIDENT, SECOND VICE PRESIDENT, SECRETARY AND TREASURER, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 3KNOXVILLE COMMUNITY HOSPITAL CONTRACTS WITH MERCYONE MEDICAL CENTER - DES MOINES FOR OVERSIGHT OF MANAGEMENT SERVICES. MERCYONE MEDICAL CENTER PROVIDES A FULL-TIME HOSPITAL CHIEF EXECUTIVE OFFICER/ADMINISTRATOR TO PROVIDE MANAGEMENT SERVICES AND ADMINISTRATIVE DIRECTION. KNOXVILLE COMMUNITY HOSPITAL PAYS MERCYONE MEDICAL CENTER FOR THE COMPENSATION OF THE CEO/ADMINISTRATOR.
FORM 990, PART VI, SECTION A, LINE 4DURING THE YEAR, THE BY-LAWS OF THE ORGANIZATION WERE AMENDED TO INCLUDE THE FOLLOWING CHANGE: THE BOARD OF DIRECTORS SHALL BE COMPRISED OF NO MORE THAN NINE MEMBERS, WHERE PREVIOUSLY, THE BOARD HAD A NINE MEMBER MINIMUM REQUIREMENT.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS SIGNED BY THE CFO PRIOR TO BEING FILED, IT IS REVIEWED BY THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING, WHICH MAY OCCUR AFTER FORM 990 HAS BEEN FILED WITH IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE COMPLIANCE OFFICER PROVIDES A COMPLIANCE OVERVIEW AND BOARD MEMBERS SIGN THE CONFLICT OF INTEREST POLICY. THE COMPLIANCE OFFICER REVIEWS THE POLICIES AND UPDATES THEM ANNUALLY. THE COMPLIANCE TEAM MEETS QUARTERLY TO REVIEW ALL COMPLIANCE AREAS AND CONFLICT OF INTEREST IS ONE OF THOSE AREAS. THE COMPLIANCE OFFICER ATTENDS SPECIAL TRAININGS ON COMPLIANCE REGULATIONS. EVERY CONFLICT OF INTEREST ONCE RECOGNIZED, MUST BE EVALUATED. IF A CONFLICT EXISTS, THE INDIVIDUAL WILL NOT BE PRESENT DURING GENERAL DISCUSSION NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15PER HUMAN RESOURCE POLICIES, KNOXVILLE COMMUNITY HOSPITAL UTILIZES THE IHA WAGE SURVEY AND COMPARATIVE ANALYSIS AND MARKET RATES. MOST WAGES ARE ADJUSTED WHEN THE BOARD OF DIRECTORS APPROVES PAY INCREASE PERCENTAGES. KNOXVILLE COMMUNITY HOSPITAL DOES PAY FOR PERFORMANCE IN CONJUNCTION WITH SALARY SURVEYS.
FORM 990, PART VI, SECTION C, LINE 19KNOXVILLE COMMUNITY HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST AT ORGANIZATION'S ADMINISTRATIVE OFFICES DURING NORMAL BUSINESS HOURS.
FORM 990, PART IX, LINE 11GOUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,816,154. MANAGEMENT AND GENERAL EXPENSES 485,934. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,302,088. NURSING SERVICES: PROGRAM SERVICE EXPENSES 244,415. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 244,415. EMERGENCY ROOM SERVICES: PROGRAM SERVICE EXPENSES 724,920. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 724,920. PHYSICAL THERAPY SERVICES: PROGRAM SERVICE EXPENSES 784,163. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 784,163. ANESTHESIA SERVICES: PROGRAM SERVICE EXPENSES 566,139. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 566,139. LAB SERVICES: PROGRAM SERVICE EXPENSES 444,972. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 444,972. NUCLEAR MEDICINE SERVICES: PROGRAM SERVICE EXPENSES 285,909. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 285,909. RESPIRATOR SERVICES: PROGRAM SERVICE EXPENSES 251,340. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 251,340.
FORM 990, PART XII, LINE 2C:THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1KNOXVILLE HOSPITAL & CLINICS FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH LINCOLN STREETAddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50138ZIPCd
FieldValueIRS element (for citing)
EIN900126510EIN
Primary ActivitiesSUPPORT FOR KNOXVILLE COMMUNITY HOSPITALPrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1KNOXVILLE COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd