RUSSELL COUNTY KENTUCKY HOSPITAL DISTRICT HEALTH FACILITY CORP INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- RUSSELL COUNTY KENTUCKY HOSPITAL DISTRICT HEALTH FACILITY CORP INC (EIN 61-0965365)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202341329349305539
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T13:12:57-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 EASTPOINT PKWY SUITE 300 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610965365 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSELL COUNTY KENTUCKY HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | DISTRICT HEALTH FACILITIES CORP | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RUSS | BusinessNameControlTxt |
| Phone | 2708664753 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1610 153 DOWELL ROAD | AddressLine1Txt |
| City | RUSSELL SPRINGS | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42642 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANIE LANDIS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2708664753 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JANIE | PersonFirstNm |
| Person Last | LANDIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMILIE M KNIERIEM CPA | PreparerPersonNm |
| PTIN | P01330194 | PTIN |
| Phone | 5029923500 | PhoneNum |
| Preparation | 2023-05-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JANIE LANDIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1610 153 DOWELL ROAD | AddressLine1Txt |
| City | RUSSELL SPRINGS | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42642 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $34,970,618 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RUSSELLCOHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY, COMPASSIONATE HEALTHCARE CONSISTENT WITH THE TRUST AND SUPPORT OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 339 | TotalEmployeeCnt |
| Total Volunteers | 33 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,809,147 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,487,772 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,177,013 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,441,675 | CYProgramServiceRevenueAmt |
| PY Investment Income | $81,928 | PYInvestmentIncomeAmt |
| CY Investment Income | $78,541 | CYInvestmentIncomeAmt |
| PY Other Revenue | $72,773 | PYOtherRevenueAmt |
| CY Other Revenue | $962,630 | CYOtherRevenueAmt |
| PY Total Revenue | $36,140,861 | PYTotalRevenueAmt |
| CY Total Revenue | $34,970,618 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $7,770 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,526,370 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,680,544 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,313,151 | PYOtherExpensesAmt |
| CY Other Expenses | $13,508,343 | CYOtherExpensesAmt |
| PY Total Expenses | $29,839,521 | PYTotalExpensesAmt |
| CY Total Expenses | $34,196,657 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,301,340 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $773,961 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,239,932 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,774,146 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,124,450 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,884,703 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,115,482 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,889,443 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY, COMPASSIONATE HEALTHCARE CONSISTENT WITH THE TRUST AND SUPPORT OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,465,804 | ExpenseAmt |
| Grant | $7,770 | GrantAmt |
| Revenue | $32,467,265 | RevenueAmt |
| Desc | MEDICAL CARE PROVIDED BY HOSPITAL TO PATIENTS - CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY $388,092 FOR THE YEAR ENDED JUNE 30, 2022. THE HOSPITAL HOLDS AN ANNUAL HEALTH FAIR FOR THE COMMUNITY WHERE IT PROVIDES REDUCED COST TESTING. THE HOSPITAL SUPPORTS ITS EMPLOYEES' COMMUNITY INVOLVEMENT AND CONDUCTS OTHER PROGRAMS FOR COMMUNITY BENEFIT. | Desc |
| Total Program Service Expenses | $28,465,804 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 339 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| 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 | JANIE LANDIS | PersonNm |
| Phone | 2708664753 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1610 153 DOWELL ROAD | AddressLine1Txt |
| City | RUSSELL SPRINGS | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42642 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| NEAL DALTON | |||||||
| CHAIRPERSON/PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DARYL HAMMOND | |||||||
| VICE CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WINFREY BATES | |||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STUART CARMAN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVEN FLETCHER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICK BRANCO | |||||||
| CEO (END 05/08/22) | 40.00 | Yes (X) | $180,642 | $0 | $14,148 | ||
| SCOTT THOMPSON | |||||||
| CEO (BEG 05/01/22) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| JANIE LANDIS | |||||||
| CFO | 40.00 | Yes (X) | $151,249 | $0 | $48,385 | ||
| JENNIFER GOODE | |||||||
| CHIEF HR OFFICER (END 4/30/22) | 40.00 | Yes (X) | $134,843 | $0 | $41,457 | ||
| JUDY WITHERS | |||||||
| CNO | 40.00 | Yes (X) | $147,210 | $0 | $29,809 | ||
| RICHARD PERKINS | |||||||
| PHYSICIAN | 40.00 | $487,331 | $0 | $41,837 | Yes (X) | ||
| JONAS HURLEY | |||||||
| PHYSICIAN | 40.00 | $509,333 | $0 | $47,536 | Yes (X) | ||
| MILTON JACKSON | |||||||
| PHYSICIAN | 40.00 | $500,827 | $0 | $34,791 | Yes (X) | ||
| TOMMY SHELTON | |||||||
| PHYSICIAN | 40.00 | $642,887 | $0 | $28,823 | Yes (X) | ||
| LIESEL GRENTZ | |||||||
| PHYSICIAN | 40.00 | $237,368 | $0 | $34,989 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,991,690 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $321,775 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STEVE AITKEN CRNA | |||||
| 919 LILY CREEK RESORT ROAD | JAMESTOWN | KY | 42629 | ANESTHESIA SERVICES | $328,899 |
| DR JASBIR DHILLON | |||||
| 5040 MURRAY LANE | BRENTWOOD | TN | 37027 | PHYSICIAN SERVICES | $220,200 |
| DR JOHN KILGALLIN | |||||
| 124 DOWELL ROAD | RUSSELL SPRINGS | KY | 42629 | PHYSICIAN SERVICES | $215,075 |
| INSIGHT DIRECT USA INC | |||||
| 2701 E INSIGHT WAY | CHANDLER | AZ | 85286 | IT SERVICES | $176,554 |
| DR JERRY LAWSON | |||||
| 276 G V HALE AVE | RUSSELL SPRINGS | KY | 42642 | PHYSICIAN SERVICES | $165,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,091,339 | GovernmentGrantsAmt |
| All Other Contributions | $396,433 | AllOtherContributionsAmt |
| Total Contributions | $1,487,772 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621999 | $29,619,180 | $29,619,180 |
| PHARMACY SERVICES - 340B | 621399 | $2,822,495 | $2,822,495 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,441,675 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,011 | TotalRevenueColumnAmt |
| Exclusion | $71,011 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,969 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,969 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,969 | TotalRevenueColumnAmt |
| Exclusion | $7,969 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $30 | SecuritiesAmt |
| Other | $7,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $30 | SecuritiesAmt |
| Other | $7,500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,530 | TotalRevenueColumnAmt |
| Exclusion | $7,530 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| ADMIN TAX REVENUE | 900099 | $909,528 | $909,528 | |
| CAFETERIA INCOME | 722310 | $24,181 | $24,181 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,952 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,409 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $19,543 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $954,661 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,970,618 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,467,265 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,015,581 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,770 | TotalAmt |
| Program Services | $7,770 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $716,897 | TotalAmt |
| Program Services | $597,751 | ProgramServicesAmt |
| Management And General | $119,146 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,948,576 | TotalAmt |
| Program Services | $13,297,967 | ProgramServicesAmt |
| Management And General | $2,650,609 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $277,098 | TotalAmt |
| Program Services | $221,678 | ProgramServicesAmt |
| Management And General | $55,420 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,547,139 | TotalAmt |
| Program Services | $2,037,712 | ProgramServicesAmt |
| Management And General | $509,427 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,190,834 | TotalAmt |
| Program Services | $952,667 | ProgramServicesAmt |
| Management And General | $238,167 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,794 | TotalAmt |
| Management And General | $25,794 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,693 | TotalAmt |
| Management And General | $61,693 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,808,667 | TotalAmt |
| Program Services | $2,622,014 | ProgramServicesAmt |
| Management And General | $186,653 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,638 | TotalAmt |
| Program Services | $963 | ProgramServicesAmt |
| Management And General | $148,675 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,048 | TotalAmt |
| Program Services | $263,800 | ProgramServicesAmt |
| Management And General | $36,248 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $835,385 | TotalAmt |
| Program Services | $814,153 | ProgramServicesAmt |
| Management And General | $21,232 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,304 | TotalAmt |
| Program Services | $27,043 | ProgramServicesAmt |
| Management And General | $3,261 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,180 | TotalAmt |
| Program Services | $6,094 | ProgramServicesAmt |
| Management And General | $86 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,479 | TotalAmt |
| Management And General | $74,479 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,083,708 | TotalAmt |
| Management And General | $1,083,708 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,754 | TotalAmt |
| Program Services | $7,222 | ProgramServicesAmt |
| Management And General | $279,532 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $6,009,492 | $6,009,492 | |
| REPAIRS AND MAINTENANCE | $1,050,030 | $1,032,213 | $17,817 |
| PROVIDER TAX | $406,158 | $406,158 | |
| FOOD & BEVERAGE | $100,706 | $100,706 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,307 | TotalAmt |
| Program Services | $60,401 | ProgramServicesAmt |
| Management And General | $218,906 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,196,657 | TotalAmt |
| Program Services | $28,465,804 | ProgramServicesAmt |
| Management And General | $5,730,853 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,706,985 | BOYAmt |
| EOY | $191,067 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,266,588 | BOYAmt |
| EOY | $11,025,800 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,368,375 | BOYAmt |
| EOY | $4,619,406 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $764,814 | BOYAmt |
| EOY | $810,022 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $799,571 | BOYAmt |
| EOY | $806,015 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,192,523 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,269,085 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,437,218 | BOYAmt |
| EOY | $5,923,438 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,365,052 | BOYAmt |
| EOY | $1,509,403 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,329 | BOYAmt |
| EOY | $3,888,995 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,239,932 | BOYAmt |
| EOY | $28,774,146 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,589,977 | BOYAmt |
| EOY | $2,634,750 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,922 | BOYAmt |
| EOY | $1,149,066 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,235,551 | BOYAmt |
| EOY | $1,600,708 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $500,179 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,124,450 | BOYAmt |
| EOY | $5,884,703 | 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 | $22,115,482 | BOYAmt |
| EOY | $22,889,443 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,115,482 | BOYAmt |
| EOY | $22,889,443 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,239,932 | BOYAmt |
| EOY | $28,774,146 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $773,961 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,482 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,482 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE PORTION OF ORGANIZATION DUES PAID TO KENTUCKY HOSPITAL ASSOCIATION FOR FYE 2022 THAT ARE RELATED TO LOBBYING ARE APPROXIMATELY 11.0%. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $344,100 | OtherCostOrOtherBasisAmt |
| Book Value | $344,100 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,389,701 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,315,391 | DepreciationAmt |
| Book Value | $3,074,310 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,251,237 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,900,690 | DepreciationAmt |
| Book Value | $2,350,547 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $207,485 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,004 | DepreciationAmt |
| Book Value | $154,481 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,923,438 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ASSETS WHOSE USE IS LIMITED | $3,873,966 |
| OTHER RECEIVABLES | $15,029 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,888,995 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY PAYABLE | Desc |
| Amt | $500,179 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $500,179 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $34,970,618 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $34,970,618 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $34,970,618 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $34,196,657 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $34,196,657 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $34,196,657 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $177,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $54,845 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $122,673 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,648,916 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,935,617 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $713,299 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,826,434 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,990,462 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $835,972 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02450 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,035 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,035 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,840,469 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,990,462 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $850,007 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02490 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,308,809 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,738,527 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,281,489 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,542,962 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSELL COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1610 153 DOWELL ROAD | AddressLine1Txt |
| City | RUSSELL SPRINGS | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42642 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.RUSSELLCOHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 600081 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSELL COUNTY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.RUSSELLCOHOSPITAL.ORG/DOCS/RUSSELL_COUNTY_HOSPITAL_CHNA_2019.PDF | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.RUSSELLCOHOSPITAL.ORG/DOCS/RCH_CHNA_IMPLEMENTATION_STRATEGY_2020-2022 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.RUSSELLCOHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIALASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.RUSSELLCOHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIALASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.RUSSELLCOHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIALASSISTANCE | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| RUSSELL COUNTY HOSPITAL | PART V, SECTION B, LINE 5: INPUT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT WAS ASKED FROM INDIVIDUALS WITH KNOWLEDGE OF THE COMMUNITY AND EXPERTISE. INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF 10 STAKEHOLDERS. |
| RUSSELL COUNTY HOSPITAL | PART V, SECTION B, LINE 11: PER A REVIEW OF THE UPDATES TO THE ACTION PLANS AND STRATEGIES LISTED IN THE IMPLEMENTATION STRATEGY, THE PRIORITIES ARE IN THE PROCESS OF BEING MET. |
| RUSSELL COUNTY HOSPITAL | PART V, SECTION B, LINE 13B: UNINSURED PATIENTS ARE CONSISTENTLY SUPPLIED WITH THE STATE DSH APPLICATION. THIS APPLICATION IS PROCESSED BY DISABILITY MEDICAL CONSULTANTS TO DETERMINE IF THE PATIENT QUALIFIES FOR KENTUCKY FINANCIAL ASSISTANCE THROUGH THE STATE PROGRAM, THEN THE PATIENT'S INFORMATION IS SCREENED FOR INTERNAL CHARITY ASSISTANCE. UNINSURED PATIENTS SCHEDULED FOR HIGH DOLLAR PROCEDURES ARE NOT SCREENED PRIOR TO SERVICE. THEY ARE SUBJECT TO THE SAME SCREENNG PROCESS AS OTHER PATIENTS. UNINSURED PATIENTS ARE NOT ROUTINELY VISITED BY FINANCIAL COUNSELORS. THEY ARE VISITED UPON REQUEST AND PROVIDED A DSH APPLICATION TO START THE SCREENING PROCESS. DISABILITY MEDICAL CONSULTANTS CONDUCT THE SCREENING FOR FINANCIAL ASSISTANCE REQUESTS. DMC REVIEWS THE PATIENT'S APPLICATION AND INCOME/ASSET INFORMATION. IN-HOUSE CHARITY ASSISTANCE IS AWARDED BASED ON A SLIDING SCALE OF INCOME AND FAMILY SIZE. A LEVEL OF ASSISTANCE IS AVAILABLE TO PATIENTS WITH INCOMES UP TO 200% OF FEDERAL POVERTY LEVEL. KENTUCKY STATE DSH ASSISTANCE IS AWARDED ONLY TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR MEDICAID. RUSSELL COUNTY HOSPITAL EXTENDS CHARITY ASSISTANCE TO ANY PATIENTS MEETING ITS INCOME GUIDELINE CRITERIA. CHARITY CARE RECIPIENTS MUST PAY TAXES IN RUSSELL COUNTY. THERE ARE NO CATASTROPHIC MAXIMUMS IN PLACE. PATIENTS CAN APPLY FOR CHARITY ASSISTANCE AND WILL BE JUDGED ON INCOME LEVELS AND FAMILY SIZE. ALSO, CHARITY CARE IS AWARDED FOR A PERIOD OF 6 MONTHS. |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | BAD DEBT AMOUNTS ON THE FINANCIAL STATEMENTS REPRESENT UNPAID CO-INSURANCE AND DEDUCTIBLES AND ALL SELF-PAY ACCOUNTS THAT GO UNPAID. AMOUNTS ARE NOT WRITTEN OFF UNTIL RUSSELL COUNTY HOSPITAL KNOWS THEY WILL NOT BE PAID. FOR LINE 3, ANY AMOUNTS THAT COULD BE LISTED WOULD BE NEGLIGIBLE AND THUS ARE NOT ESTIMATED. RUSSELL COUNTY HOSPITAL HAS A POLICY OF PROVIDING CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. SUCH PATIENTS ARE IDENTIFIED BASED ON FINANCIAL INFORMATION OBTAINED FROM THE PATIENT AND SUBSEQUENT ANALYSIS. SINCE RUSSELL COUNTY HOSPITAL DOES NOT EXPECT PAYMENT, ESTIMATED CHARGES FOR CHARITY CARE ARE NOT REPORTED IN NET REVENUE, AND THUS WOULD NOT BE WRITTEN OFF TO BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL. LINE 6 COSTS REPRESENT MEDICARE CHARGES MULTIPLIED BY A CALCULATED COST-TO-CHARGE RATIO FOR ANCILLARY SERVICES AND MEDICARE DAYS MULTIPLIED BY A CALCULATED PER DIEM AMOUNT FOR ROUTINE SERVICES. |
| PART III, LINE 9B: | FOR ANY PATIENT WHO MAY OR IS KNOWN TO QUALIFY FOR SERVICES UNDER CHARITY CARE, THE COLLECTION POLICY PROVIDES THAT THE HOSPITAL SHOULD GATHER SUPPORTING DOCUMENTATION AND DETERMINE WHETHER THE PATIENT NEEDS TO PAY. |
| PART VI, LINE 2: | IDENTIFIED HEALTH NEEDS WERE PRIORITIZED WITH INPUT FROM MEMBERS OF THE HOSPITAL'S MANAGEMENT TEAM UTILIZING A WEIGHTING METHOD THAT WEIGHS 1) THE SIZE OF THE PROBLEM, 2) THE SERIOUSNESS OF THE PROBLEM, 3) THE IMPACT OF THE ISSUES ON VULNERABLE POPULATIONS, 4) HOW IMPORTANT THE ISSUE IS TO THE COMMUNITY AND 5) THE PREVALENCE OF COMMON THEMES. SIGNIFICANT NEEDS WERE FURTHER REVIEWED AND ANALYZED REGARDING HOW CLOSELY THE NEED ALIGNS WITH THE HOSPITAL'S MISSION, CURRENT AND KEY SERVICE LINES, AND/OR STRATEGIC PRIORITIES. |
| PART VI, LINE 3: | EACH PATIENT IS INSTRUCTED ABOUT THE FINANCIAL ASSISTANCE POLICY AS THEY REGISTER FOR SERVICE. PATIENTS WITHOUT INSURANCE ARE ASKED TO COMPLETE A SHORT FORM TO DETERMINE THEIR ELIGIBILITY FOR CHARITY OR GOVERNMENT PROGRAMS. |
| PART VI, LINE 4: | THE HOSPITAL SERVICES A POPULATION OF MORE THAN 18,000 IN RUSSELL COUNTY KENTUCKY, AS WELL AS PEOPLE IN THE SURROUNDING COUNTIES. RUSSELL COUNTY, KENTUCKY IS COMPRISED OF APPROXIMATELY 49% MALE AND 51% FEMALE. APPROXIMATELY 96% OF THE POPULATION IS CAUCASIAN. THE MEDIAN HOUSEHOLD INCOME IS $30,272, WITH APPROXIMATELY 22% OF THE POPULATION BELOW POVERTY LEVEL. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TOMMY SHELTON | ||||||||||||||
| PHYSICIAN | $641,502 | $0 | $1,250 | $0 | $135 | $0 | $5,800 | $0 | $23,023 | $0 | $671,710 | $0 | $0 | $0 |
| JONAS HURLEY | ||||||||||||||
| PHYSICIAN | $463,384 | $0 | $1,250 | $0 | $44,699 | $0 | $2,289 | $0 | $45,247 | $0 | $556,869 | $0 | $0 | $0 |
| MILTON JACKSON | ||||||||||||||
| PHYSICIAN | $498,389 | $0 | $1,250 | $0 | $1,188 | $0 | $5,800 | $0 | $28,991 | $0 | $535,618 | $0 | $0 | $0 |
| RICHARD PERKINS | ||||||||||||||
| PHYSICIAN | $453,163 | $0 | $0 | $0 | $34,168 | $0 | $4,946 | $0 | $36,891 | $0 | $529,168 | $0 | $0 | $0 |
| LIESEL GRENTZ | ||||||||||||||
| PHYSICIAN | $235,848 | $0 | $1,250 | $0 | $270 | $0 | $4,065 | $0 | $30,924 | $0 | $272,357 | $0 | $0 | $0 |
| JANIE LANDIS | ||||||||||||||
| CFO | $122,911 | $0 | $1,250 | $0 | $27,088 | $0 | $2,904 | $0 | $45,481 | $0 | $199,634 | $0 | $0 | $0 |
| PATRICK BRANCO | ||||||||||||||
| CEO (END 05/08/22) | $177,281 | $0 | $0 | $0 | $3,361 | $0 | $3,598 | $0 | $10,550 | $0 | $194,790 | $0 | $0 | $0 |
| JUDY WITHERS | ||||||||||||||
| CNO | $132,534 | $0 | $1,250 | $0 | $13,426 | $0 | $2,961 | $0 | $26,848 | $0 | $177,019 | $0 | $0 | $0 |
| JENNIFER GOODE | ||||||||||||||
| CHIEF HR OFFICER (END 4/30/22) | $111,701 | $0 | $0 | $0 | $23,142 | $0 | $2,653 | $0 | $38,804 | $0 | $176,300 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | PER THE BYLAWS, THERE IS NO OTHER COMMITTE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO ARE PROVIDED WITH A COPY OF THE 990 TO REVIEW IN ITS ENTIRETY BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE PREPARED AND REVEIWED ANNUALLY TO DETERMINE IF ANY CONFLICTS EXIST. FURTHER, CONFLICT ACTIVITY IS MONITORED THROUGHOUT THE YEAR TO MAKE SURE THAT CONFLICTS OF INTEREST DO NOT ARISE. SHOULD A CONFLICT ARISE, THE BOARD MEMBER WILL ABSTAIN FROM VOTING ON THE MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | LINE 15A: THE BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION AND REVIEWS IT ANNUALLY. COMPENSATION SURVEYS AND EMPLOYMENT CONTRACTS ARE USED DURING THE PROCESS, WHICH IS REVEIWED ANNUALLY. LINE 15B: THE CEO, WITH APPROVAL FROM THE BOARD, DETERMINES THE CFO AND OTHER TOP MANAGEMENT OFFICIALS' COMPENSATION. COMPENSATION SURVEYS AND EMPLOYMENT CONTRACTS ARE USED DURING THE PROCESS, WHICH IS REVEIWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND AT THE DISCRETION OF THE BOARD OF DIRECTORS AND MANAGEMENT. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSELL COUNTY MEDICAL CLINIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1328 | AddressLine1Txt |
| City | RUSSELL SPRINGS | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42642 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSELL COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | EXCLUDED | PredominantIncomeTypeTxt |
| Share Of Total Income | $7,706 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $5,140 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.85720 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |