DEACONESS UNION COUNTY HOSPITAL INC: Form 990, tax year 2021
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- Organization
- DEACONESS UNION COUNTY HOSPITAL INC (EIN 86-2614124)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-15
- IRS object ID
- 202322279349303787
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-15T15:30:02-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | 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 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 862614124 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEACONESS UNION COUNTY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DEAC | BusinessNameControlTxt |
| Phone | 2703895000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4604 US HWY 60 | AddressLine1Txt |
| City | MORGANFIELD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42437 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMBER POWELL | PersonNm |
| Person Title | CNO | PersonTitleTxt |
| Phone | 2703895085 | PhoneNum |
| Signature | 2023-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | AMBER | PersonFirstNm |
| Person Last | POWELL | 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 | 3176334705 | PhoneNum |
| Preparation | 2023-08-15 | 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) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Application Pending | Yes (X) | ApplicationPendingInd |
| Principal Officer | AMBER POWELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4604 US HWY 60 | AddressLine1Txt |
| City | MORGANFIELD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42437 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,377,740 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DEACONESS.COM/DEACONESS-UNION-COUNTY-HOSPITAL | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | DEACONESS UNION COUNTY HOSPITAL OFFERS A 24-HOUR EMERGENCY DEPARTMENT, A HOSPITAL-BASED AMBULANCE SERVICE AND A FULL RANGE OF DIAGNOSTIC SERVICES INCLUDING LAB, IMAGING, AND MAMMOGRAPHY, AS WELL PHYSICAL THERAPY, CARDIOPULMONARY CARE, AND SURGICAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 123 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $232,938 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $27,117,332 | CYProgramServiceRevenueAmt |
| CY Investment Income | $182 | CYInvestmentIncomeAmt |
| CY Other Revenue | $27,288 | CYOtherRevenueAmt |
| CY Total Revenue | $27,377,740 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $11,474,610 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $14,110,077 | CYOtherExpensesAmt |
| CY Total Expenses | $25,584,687 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $1,793,053 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $27,282,215 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $17,988,751 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $9,293,464 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SAME AS ABOVE | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,501,304 | ExpenseAmt |
| Revenue | $27,117,332 | RevenueAmt |
| Desc | DEACONESS HOSPITAL UNION COUNTY IS A CRITICAL ACCESS HOSPITAL IN UNION COUNTY, KY. DURING FY 2022, DEACONESS UNION COUNTY HOSPITAL SERVED 460 INPATIENTS FOR A TOTAL OF 3,324 INPATIENT DAYS. UNION COUNTY ALSO PROVIDED 6,643 EMERGENCY ROOM VISITS. | Desc |
| Total Program Service Expenses | $21,501,304 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | 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 | 26 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 123 | 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERYL A WATHEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8124503296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MARY STREET | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47747 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| ADAM O'NAN | |||||||
| CHAIRPERSON | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PATRICIA SHEFFER | |||||||
| VICE CHAIRPERSON | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TESSA GOUGH | |||||||
| SECRETARY / TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GARLAND CERTAIN | |||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DR WILLIAM ALLEN WHITE | |||||||
| MEMBER | 2.00 | 56.00 | Yes (X) | $0 | $421,689 | $82,077 | |
| MARC JARED FLORENCE | |||||||
| MEMBER | 2.00 | 66.00 | Yes (X) | $0 | $572,429 | $128,115 | |
| JARED SIMPSON | |||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $212,463 | $6,299 | |
| PAMELA HUNT | |||||||
| SR. EXEC. ASST | 50.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CLAUDIA EISENMANN | |||||||
| VP CRITICAL ACCESS HOSP. | 35.00 | 25.00 | Yes (X) | $199,169 | $199,169 | $29,340 | |
| JESSICA R LATHAM | |||||||
| CFO - TERM BEGAN 12/22 | 50.00 | 0.00 | Yes (X) | $99,850 | $0 | $9,599 | |
| AMBER N POWELL | |||||||
| CNO | 50.00 | 0.00 | Yes (X) | $0 | $132,830 | $37,416 | |
| JANET G JAMES | |||||||
| INTERIM CAO - TERM 4/22-11/22 | 50.00 | 0.00 | Yes (X) | $0 | $138,194 | $14,689 | |
| AUDREY O'NAN | |||||||
| DIRECTOR OF HR | 50.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $299,019 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,676,774 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $307,535 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CONCORD MEDICAL GROUP | |||||
| 1602 AVE Q | LUBBOCK | TX | 79401 | EMERGENCY SERVICES | $306,488 |
| PROGRESSIVE HEALTH OF INDIANA | |||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47710 | THERAPY SERVICES | $245,932 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $223,879 | GovernmentGrantsAmt |
| All Other Contributions | $9,059 | AllOtherContributionsAmt |
| Total Contributions | $232,938 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OUTPATIENT | 621400 | $46,570,563 | $46,570,563 |
| INPATIENT | 621400 | $10,661,338 | $10,661,338 |
| PHYSICIAN SERVICES | 621400 | $6,174,118 | $6,174,118 |
| ALL OTHER | 621400 | $58,664 | $58,664 |
| CONTRACTUAL ALLOWANCES / BAD DEBT | 621400 | -$36,347,351 | -$36,347,351 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,117,332 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $182 | TotalRevenueColumnAmt |
| Exclusion | $182 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,288 | 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 | $27,288 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,288 | TotalRevenueColumnAmt |
| Exclusion | $27,288 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,377,740 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,117,332 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $27,470 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,019 | TotalAmt |
| Program Services | $266,127 | ProgramServicesAmt |
| Management And General | $32,892 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,810,206 | TotalAmt |
| Program Services | $7,841,083 | ProgramServicesAmt |
| Management And General | $969,123 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,990 | TotalAmt |
| Program Services | $137,941 | ProgramServicesAmt |
| Management And General | $17,049 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500,191 | TotalAmt |
| Program Services | $1,335,170 | ProgramServicesAmt |
| Management And General | $165,021 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $710,204 | TotalAmt |
| Program Services | $632,082 | ProgramServicesAmt |
| Management And General | $78,122 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,079 | TotalAmt |
| Management And General | $80,079 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,010,751 | TotalAmt |
| Program Services | $4,147,418 | ProgramServicesAmt |
| Management And General | $1,863,333 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,909 | TotalAmt |
| Program Services | $21,279 | ProgramServicesAmt |
| Management And General | $2,630 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,388,257 | TotalAmt |
| Program Services | $2,125,549 | ProgramServicesAmt |
| Management And General | $262,708 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,116 | TotalAmt |
| Program Services | $133,507 | ProgramServicesAmt |
| Management And General | $11,609 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $828,698 | TotalAmt |
| Program Services | $737,541 | ProgramServicesAmt |
| Management And General | $91,157 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,548 | TotalAmt |
| Program Services | $10,278 | ProgramServicesAmt |
| Management And General | $1,270 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,733 | TotalAmt |
| Program Services | $20,232 | ProgramServicesAmt |
| Management And General | $2,501 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,627 | TotalAmt |
| Program Services | $247,978 | ProgramServicesAmt |
| Management And General | $30,649 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,390,453 | TotalAmt |
| Program Services | $1,237,503 | ProgramServicesAmt |
| Management And General | $152,950 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,330 | TotalAmt |
| Program Services | $142,694 | ProgramServicesAmt |
| Management And General | $17,636 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OH ALLOCATION | $2,026,839 | $1,803,887 | $222,952 |
| TAX EXPENSE | $315,653 | $280,931 | $34,722 |
| REPAIRS AND MAINTENANCE | $220,516 | $196,259 | $24,257 |
| DUES & SUB | $32,723 | $29,123 | $3,600 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,845 | TotalAmt |
| Program Services | $154,722 | ProgramServicesAmt |
| Management And General | $19,123 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,584,687 | TotalAmt |
| Program Services | $21,501,304 | ProgramServicesAmt |
| Management And General | $4,083,383 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $11,193,647 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,075,406 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $481,072 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $89,012 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,116,078 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,117,553 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $7,998,525 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $5,444,553 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $27,282,215 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,422,659 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,595,149 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $9,970,943 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $17,988,751 | 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 | $0 | BOYAmt |
| EOY | $9,293,464 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $9,293,464 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $27,282,215 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,793,053 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $7,500,411 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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 | $1,205 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,205 | 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, LOBBYING ACTIVITIES | FormAndLineReferenceDesc |
| Explanation | MEMBERSHIP DUES TO HOSPITAL ASSOCIATION OF WHICH A PORTION OF THE DUES ARE USED FOR LOBBYING EXPENSES BY THE TRADE ORGANIZATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,018 | OtherCostOrOtherBasisAmt |
| Book Value | $16,018 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,198,971 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,153,173 | DepreciationAmt |
| Book Value | $6,045,798 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,814,251 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,964,380 | DepreciationAmt |
| Book Value | $1,849,871 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $86,838 | OtherCostOrOtherBasisAmt |
| Book Value | $86,838 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,998,525 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER A/R | $6,628 |
| INTERCOMPANY REC. | $5,316,333 |
| RIGHT OF USE ASSET | $108,763 |
| OTHER | $12,829 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,444,553 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES | $9,004,012 |
| RIGHT OF USE LEASE | $108,763 |
| OTHER | $858,168 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,970,943 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2022 AND 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | 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 |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $437,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $437,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01710 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,794,048 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,784,788 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,231,636 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,784,788 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $437,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01710 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 198 | PersonsServedCnt |
| Total Community Benefit Expns | $3,054 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10 | PersonsServedCnt |
| Total Community Benefit Expns | $22,596 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,596 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1471 | PersonsServedCnt |
| Total Community Benefit Expns | $1,422 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1679 | PersonsServedCnt |
| Total Community Benefit Expns | $27,072 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1679 | PersonsServedCnt |
| Total Community Benefit Expns | $6,258,708 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,784,788 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $464,660 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01820 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $390 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $544 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $544 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $934 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $934 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $233,306 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $13,724,805 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,388,173 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $336,632 | 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 | DEACONESS UNION COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4604 US HWY 60 W | AddressLine1Txt |
| City | MORGANFIELD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42437 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 600057 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| 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 | DEACONESS UNION COUNTY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.DEACONESSS.COM/CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.DEACONESS.COM/CHNA | 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 | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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 |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DEACONESS UNION COUNTY HOSPITAL | PART V, SECTION B, LINE 5: DEACONESS UNION COUNTY HOSPITAL CONSULTED WITH THE FOLLOWING GROUPS TO GATHER INPUT AND DATA: DEACONESS HEALTH SYSTEM GREEN RIVER DISTRICT HEALTH DEPARTMENT UNION COUNTY FAMILY DENTAL UNION COUNTY HEALTH CENTER UNION COUNTY SENIOR SERVICESA DIVERSE AND COMPREHENSIVE RANGE OF ACTIVITIES WERE INITIATED TO COLLECT AND CONSIDER DATA THAT PROVIDED VALUABLE INSIGHTS FOR DECISION MAKING. A FOUNDATIONAL ACTIVITY INCLUDED THE REVIEW OF EXISTING SECONDARY DATA TO BETTER UNDERSTAND THE HEALTH NEEDS AND SOCIAL, ECONOMIC, AND DEMOGRAPHIC CHARACTERISTICS OF THOSE LIVING IN THE SERVICE AREA. ADDITIONALLY, TO ENSURE THE CONSIDERATION OF COMMUNITY MEMBER INSIGHTS INTO THE HEALTH ISSUES IMPACTING THEIR COMMUNITIES, A PROVIDER/STAKEHOLDER SURVEY WAS CONDUCTED. LASTLY, VIRTUAL FOCUS GROUPS THAT INCLUDED COMMUNITY MEMBERS AND STAKEHOLDERS REPRESENTING ORGANIZATIONS PROVIDING SERVICES ON THE FRONT LINES OF PUBLIC HEALTH IN THEIR COMMUNITIES WERE CONDUCTED. A PRIORITIZATION SESSION WAS HELD TO DISCUSS FINDINGS AND IDENTIFY AREAS OF FOCUS FOR SUBSEQUENT YEARS. THIS RESULTED IN FOUR IDENTIFIED PRIORITIES. |
| DEACONESS UNION COUNTY HOSPITAL | PART V, SECTION B, LINE 6B: KEY PARTNER ORGANIZATIONS INCLUDED GREEN RIVER DISTRICT HEALTH DEPARTMENT, GREEN RIVER REGIONAL HEALTH COUNCIL, HEALTHY HENDERSON HEALTH COALITION, RIVER VALLEY BEHAVIORAL HEALTH, UNION COUNTY HEALTH COALITION, WEBSTER COUNTY EXTENSION OFFICE, AND WEBSTER COUNTY HEALTH COALITION. |
| DEACONESS UNION COUNTY HOSPITAL | PART V, SECTION B, LINE 7D: COPIES ARE AVAILABLE AT DEACONESS.COM/CHNA TO RECEIVE A PAPER COPY OF THE REPORT AT ZERO COST, EMAIL CAN BE SENT TO CHNA@DEACONESS.COM. |
| DEACONESS UNION COUNTY HOSPITAL | PART V, SECTION B, LINE 11: THE SIGNIFICANT NEEDS IDENTIFIED IN THE 2021 CHNA ARE SIMILAR TO THOSE ADOPTED IN PREVIOUS PLANS: ACCESS TO CARE, MENTAL HEALTH, SENIOR CARE, AND SUBSTANCE ABUSE/ALCOHOL/TOBACCO USE. THE CURRENT CHNA ALSO INCLUDES THE CONSIDERATION OF HEALTH EQUITY AND ACCESS TO EACH NEED.MOST COMMUNITY EVENTS HAD PICKED BACK UP DURING THIS YEAR. DEACONESS UNION COUNTY HOSPITAL WAS ABLE TO HAVE A COMMUNITY HEALTH FAIR WHERE HEALTH INFORMATION WAS DISTRIBUTED AND FREE HEALTH SCREENINGS WERE CONDUCTED. - DIABETES - BLOOD PRESSURE - STROKE SCREENINGDEACONESS UNION COUNTY ALSO PARTICIPATED IN A COMMUNITY WIDE BABY SHOWER WITH INFORMATION PRESENTED BY LOCAL OB/GYN PROVIDERS. THIS WAS AN EDUCATION EVENT FOR PREGNANT MOTHERS ON PRE-NATAL CARE. MORE EDUCATIONS EVENTS ARE BEING PLANNED THE COMING YEAR.SEVERAL HEALTH EDUCATION POSTS ARE DISTRIBUTED THROUGHOUT THE YEAR ON SOCIAL MEDIA. |
| DEACONESS UNION COUNTY HOSPITAL | PART V, SECTION B, LINE 15E: WELLFUND IS AVAILABLE TO DEACONESS UNION COUNTY HOSPITAL PATIENTS TO ASSIST WITH APPLYING FOR MEDICAID OR EXCHANGE PRODUCTS. |
| DEACONESS UNION COUNTY HOSPITAL | PART V, SECTION B, LINE 24: ALL PAYERS, INCLUDING ENTITLEMENT PROGRAMS, INSURANCE COMPANIES AND PATIENTS WITHOUT INSURANCE ARE BILLED AT THE HOSPITAL'S STANDARD RATE. REIMBURSEMENT AND DISCOUNTS ARE BASED ON ENTITLEMENT ALLOWABLE CONTRACTUALLY, MUTUALLY AGREEABLE REDUCTIONS OF CHARGES WITH INSURANCE COMPANIES AND MUTUALLY AGREEABLE REDUCTIONS OF CHARGES WITH PATIENTS. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST TO CHARGE RATIO WAS USED FOR MOST OF THE CALCULATIONS FOR THE TABLE. WORKSHEET 2 WAS USED FOR THIS CALCULATION. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING PERCENTAGE IN THIS COLUMN IS $0.00. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES INCLUDE THE HOSPITAL'S PARTICIPATION WITH GREEN RIVER AREA DISTRICT DEVELOPMENT, A LOCAL GROUP DEDICATED TO ADDRESSING THE HEALTHCARE NEEDS OF COMMUNITIES SERVED. ALSO, A PART OF COMMUNITY BUILDING ACTIVITIES, VARIOUS HOSPITAL ADMINISTRATION STAFF VOLUNTEER TIME AS BOARD MEMBERS OR MEMBERS OF COMMUNITY ORGANIZATION AND COALITIONS TO KEEP ABREAST OF HEALTHCARE NEEDS, CONCERNS AND ISSUES WITHIN THE AREA. |
| PART III, LINE 2: | THE HOSPITAL HAS AGREEMENTS WITH THIRD PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD PARTY PAYORS, AND OTHER FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD PARTY PAYORS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. THE HOSPITAL ESTIMATES AN ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE BASED ON EVALUATION OF THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS AND OTHER FACTORS UNIQUE TO THE SERVICE AREA AND THE HEALTHCARE INDUSTRY. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 2 IS USING THE COST-TO-CHARGE RATIO. THE RATIO WAS CALCULATED FROM WORKSHEET A, ESTIMATED BAD DEBT EXPENSE (AT COST). |
| PART III, LINE 4: | THE FOOTNOTE DESCRIBING BAD DEBT EXPENSE IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE" ON PAGE 10 AND "CHARITY CARE, COMMUNITY BENEFIT AND ASSISTANCE TO THE UNINSURED" STARTING ON PAGE 11. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS ARE DERIVED FROM UTILIZING THE COST TO CHARGE RATIO FOR THE 9/30/2022 FISCAL YEAR. THE CALCULATION INCLUDED MEDICARE INPATIENT AND OUTPATIENT COSTS LESS MEDICARE REIMBURSEMENT. |
| PART III, LINE 9B: | HOSPITAL POLICY ON CHARITY CARE PROVIDES GUIDANCE ON HOW TO PROVIDE FINANCIAL ASSISTANCE FOR PATIENTS IN NEED. HOSPITAL POLICY ON INDIGENT CARE OUTLINES THE DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAM THROUGH THE STATE OF INDIANA TO SERVE THE INDIGENT CARE NEEDS OF ALL PATIENTS WITHOUT ANY TYPE OF HEALTH INSURANCE. PATIENTS MUST COMPLETE A DSH APPLICATION AND MEET THE INDIANA DEPARTMENT OF MEDICAID SERVICES DSH PROGRAM MANUAL GUIDELINES. |
| PART VI, LINE 2: | DEACONESS UTILIZES A VARIETY OF SOURCES TO GATHER DATA ON LOCAL HEALTH CARE NEEDS. WE USE DATA FROM THE UNITED WAY OF SOUTHWESTERN INDIANA'S COMPREHENSIVE NEEDS ASSESSMENT, COUNTY HEALTH RANKINGS WEBSITE, INDIANA STATE DEPARTMENT OF HEALTH, KENTUCKY DEPARTMENT FOR PUBLIC HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU. ADDITIONAL INFORMATION COMES FROM OUR OWN ELECTRONIC MEDICAL RECORD SYSTEM AND THROUGH OUR INTERACTION WITH LOCAL SERVICE PROVIDERS AND OTHER NON-PROFIT ORGANIZATIONS. |
| PART VI, LINE 3: | HOSPITAL HAS FINANCIAL COUNSELORS TO INTERVIEW PATIENTS WHO MAY HAVE FINANCIAL NEED. THE PROCESS IS PART OF PATIENT REGISTRATION. AN INTERVIEW CAN TAKE PLACE AT ANY TIME THE PATIENT IS IN THE HOSPITAL. AFTER THE PATIENT LEAVES THE HOSPITAL, CONTACT IS MADE IN AN EFFORT TO ASSIST THE INDIVIDUAL WITH APPLYING FOR GOVERNMENT ENTITLEMENT PROGRAMS. EACH PATIENT REGISTERED AS A SELF-PAY AUTOMATICALLY RECEIVES PRINTED INFORMATION TITLED "ELIGIBILITY FOR FINANCIAL ASSISTANCE." THIS DOCUMENT EXPLAINS ABOUT THE KENTUCKY MEDICAID DISPROPORTIONATE SHARE HOSPITAL DSH PROGRAM. IT CONTAINS A LIST OF INFORMATION THE PATIENT IS REQUIRED TO PROVIDE WITH THE DSH APPLICATION, ELIGIBILITY FOR THE PROGRAM IS DETERMINED FROM THE SUBMITTED DOCUMENTS. IF THE PATIENT DOES NOT QUALIFY FOR THE DSH PROGRAM THEN THE DOCUMENTATION IS USED BY THE HOSPITAL FOR FINANCIAL ASSISTANCE DETERMINATION. IN ADDITION, DISCUSSION WITH PATIENTS CONCERNING VARIOUS PROGRAMS, HOSPITAL ASSISTANCE, ETC. |
| PART VI, LINE 4: | UNION COUNTY IS LOCATED IN WESTERN KENTUCKY AND BORDERS SOUTHEASTERN ILLINOIS. THE GREEN RIVER DISTRICT COMMUNITY HEALTH ASSESSMENT 2021 UPDATE ESTIMATES A GENERAL POPULATION AT 14,381. THE COUNTY IDENTIFIES AS 86.9% WHITE, 7.6% BLACK, OR AFRICAN AMERICAN, 1.4% HISPANIC OR LATINO, 4.3% TWO OR MORE RACES. COUNTY HEALTH RANKINGS 2021 REPORTS UNION COUNTY AS #88 OUT OF 120 COUNTIES FOR HEALTH OUTCOMES AND #69 OUT OF 120 COUNTIES FOR HEALTH FACTORS. STATISTICS FOR LOW BIRTHWEIGHT, ACCESS TO EXERCISE OPPORTUNITIES, INJURY DEATH, FIREARM FATALITIES, AND SUICIDE RANK HIGHER THAN THE STATE AVERAGE. UNION COUNTY IS MORE RURAL THAN MOST OF THE STATE (65.3% AND 40.8% RESPECTIVELY). |
| PART VI, LINE 5: | THE COVID-19 CONTINUED TO BE A PRIORITY AND THE CONSTANT CONCERN THROUGHOUT THE YEAR. WE SHIFTED FROM PRIMARY VACCINATIONS TO BOOSTERS FOR ADULTS AND CHILDREN AT ON-SITE AND DRIVE UP CLINICS. DEACONESS CONTINUED TO LEAD THE COVID-19 RESPONSE FOR SOUTHWEST INDIANA AND NEIGHBORING COUNTIES IN KENTUCKY AND ILLINOIS. WE ALSO CONTINUED TO SHARE ALL THE MOST CURRENT INFORMATION ABOUT COVID INPATIENT NUMBERS, TESTING, VACCINES, AND THE CONSTANTLY CHANGING REGULATIONS. AND OUR COPING WITH COVID WEBPAGE LINKED PEOPLE TO A VARIETY OF RESOURCES ABOUT MENTAL AND EMOTIONAL HEALTH CONTINUED TO BE A RESOURCE USED BY THE PUBLIC. AS WE STARTED TO OPEN BACK UP AND HOLD A FEW PUBLIC EVENTS WE HELD OUR ANNUAL ORAL, HEAD AND NECK CANCER SCREENING EVENT. ADDITIONALLY, WE CREATED AND DISTRIBUTED WRITTEN AND VISUAL CONTENT THAT ADDRESSED SPECIFIC ISSUES AND HEALTH CONCERNS FOR OUR COMMUNITY.WE WERE ALSO LOCAL SPONSORSHIPS USING $1,422 AND 1,471 PEOPLE.E-NEWSLETTER ARTICLES:SEPTEMBER 2022 COVID-19 VACCINES AND CHILDRENAUGUST 2022 COVID-19 VARIANTS AND VACCINESMARCH 2022 MEDICARE AND COVIDSOCIAL MEDIA POSTS:MULTIPLE POSTS ABOUT COVID VACCINES AND BOOSTERS NOVEMBER 5, 2021 CHILDREN COVID VACCINESNOVEMBER 15, 2021 DIABETES AWARENESSNOVEMBER 17, 2021 COPD VIDEO WITH DR. GUPTADECEMBER 2, 2021 PREGNANCY DURING COVID DECEMBER 6, 2021 INFLUENZA WEEK GET YOUR FLU SHOTFEBRUARY 9, 2022 WARNING SIGNS OF AFIB VIDEO DR. KUMBARFEBRUARY 18, 2022 WARNING SIGNS OF A HEART ATTACK DR. KUMBARFEBRUARY 25, 2022 HEART HEALTH PATIENT STORY VIDEOFEBRUARY 26, 2022 HEART HEALTH PATIENT STORY VIDEOMARCH 1, 2022 COLON CANCER AWARENESSMARCH 4, 2022 FACEBOOK LIVE DRS AHMED AND TETANGCO COLORECTAL CANCERMARCH 11, 2022 BREAST CANCER AWARENESS DR. JULIE FRANZMARCH 17, 2022 BRAIN INJURY AWARENESS WEAR A HELMETMARCH 22, 2022 MISSED MAMMOGRAMS DUE TO PANDEMIC VIDEOAPRIL 20, 2022 ORAL HEAD AND NECK CANCER APRIL 21, 2022 DIABETES MANAGEMENT VIDEOAPRIL 22, 2022 MENTAL HEALTH VIDEO WITH SCOTT BRANUMMAY 5, 2022 ARTHRITIS AWARENESSMAY 19, 2022 STROKE AWARENESSMAY 24, 2022 MENTAL HEALTH AWARENESS WHERE TO GO FOR HELPMAY 24, 2022 COVID BOOSTER SHOTS FOR CHILDRENMAY 26, 2022 SKIN CANCER AWARENESS TIPSJUNE 14, 2022 HEAT RELATED SAFETY TIPS WITH DR. GINA HUHNKEJUNE 30, 2022 STAYING SAFE OVER THE 4TH OF JULY WITH DR. GINA HUHNKEJULY 7 2022 ORGAN DONATIONS INFORMATIONAUGUST 9 2022 IMMUNIZATIONS AND VACCINATIONSAUGUST 9, 2022 BONE HEALTH VIDEO WITH NP, ALICIA WHEATLEYAUGUST 11, 2022 BONE HEALTHAUGUST 17, 2022 BACK TO SCHOOL SAFETYAUGUST 18, 2022 IMMUNIZATION AWARENESS SEPTEMBER 2, 2022 HOW TO WASH YOUR HANDS CORRECTLYSEPTEMBER 8, 2022 SUICIDE AWARENESSSEPTEMBER 9, 2022 PROSTATE CANCER AWARENESSSEPTEMBER 23, 2022 DRIVE THRU FLU CLINICS AND COVID BOOSTERSSEPTEMBER 6, 13, 20, 27, 2022 SEPSIS AWARENESS POSTSSEPTEMBER 28, 2022 FLU SHOT CLINICSEPTEMBER 29, 2022 HEALTHY AGING TIPS |
| PART VI, LINE 7, REPORTS FILED WITH STATES | KY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARC JARED FLORENCE | ||||||||||||||
| MEMBER | $0 | $388,454 | $0 | $115,908 | $0 | $68,067 | $0 | $93,649 | $0 | $34,466 | $0 | $700,544 | $0 | $64,307 |
| DR WILLIAM ALLEN WHITE | ||||||||||||||
| MEMBER | $0 | $271,719 | $0 | $93,777 | $0 | $56,193 | $0 | $48,296 | $0 | $33,781 | $0 | $503,766 | $0 | $44,141 |
| CLAUDIA EISENMANN | ||||||||||||||
| VP CRITICAL ACCESS HOSP. | $167,226 | $167,226 | $30,691 | $30,691 | $1,252 | $1,252 | $9,592 | $9,592 | $5,078 | $5,078 | $213,839 | $213,839 | $0 | $0 |
| JARED SIMPSON | ||||||||||||||
| MEMBER | $0 | $182,442 | $0 | $30,021 | $0 | $0 | $0 | $14,089 | $0 | $18,455 | $0 | $245,007 | $0 | $0 |
| AMBER N POWELL | ||||||||||||||
| CNO | $0 | $116,196 | $0 | $12,112 | $0 | $4,522 | $0 | $9,265 | $0 | $28,151 | $0 | $170,246 | $0 | $0 |
| JANET G JAMES | ||||||||||||||
| INTERIM CAO - TERM 4/22-11/22 | $0 | $122,098 | $0 | $15,483 | $0 | $613 | $0 | $7,823 | $0 | $6,866 | $0 | $152,883 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED W. ALLEN WHITE, MD $ -0- $ 19,500 $ -0- MARC FLORENCE $ -0- $ 19,500 $ -0- PART 1, LINE 4B: WILLIAM WHITE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF 37,856. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF 44,141. MARC FLORENCE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF 70,093. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF 64,307. |
| PART I, LINE 7 | PHYSICIANS ARE ELIGIBLE FOR INCENTIVE COMPENSATION. THE PHYSICIAN IS COMPENSATED FOR EACH WORK RVU PERFORMED BY A PHYSICIAN IN A CALENDAR YEAR IN EXCESS OF THE PHYSICIAN'S WORK RVU INCENTIVE THRESHOLD FOR THE CALENDAR YEAR MULTIPLIED BY THE INCENTIVE RVU PAYMENT. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| ALLISON JOSE | |||
| FAMILY MEMBER OF DR. WILLIAM ALLEN WHITE, BOARD MEMBER | $14,632 | COMPENSATION | 0 |
| CELESTE BEAVEN | |||
| FAMILY MEMBER OF TESSA GOUGH, BOARD MEMBER | $15,082 | COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | DEACONESS HEALTH KENTUCKY, INC. IS THE SOLE CORPORATE MEMBER OF METHODIST HEALTH, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | FIVE INDIVIDUALS ARE APPOINTED TO THE BOARD BY THE SOLE MEMBER, DEACONESS HEALTH OF KENTUCKY, INC. FOUR INDIVIUDALS ARE APPOINTED TO THE BOARD BY A MAJORITY VOTE OF THE MEMBERS PRESEENT AT A MEETING OF THE ADVISORY BOARD CALLED FOR SUCH PURPOSE AT WHICH A QUORUM IS PRESENT AND COLLECTIVELY WITH THE DHKY DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE IRS FORM 990 IS PRESENTED TO DH CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW AND ALL QUESTIONS HAVE BEEN ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM PRIOR TO FILING. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FILING OF THE FORM IS COMPLETED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HEALTH'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT AND ANNUALLY THERAFTER, OFFICERS, TRUSTEES, DIRECTORS, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS ARE REQUIRED TO COMPLETE THE CONFLICTS OF INTEREST AND/OR THE DISCLOSURE QUESTIONNAIRE. THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUSTIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS ON A PERIODIC BASES. REVIEWS OCCUR TO ENSURE METHODST HEALTH OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS METHODIST HEALTH UTILIZES THE DEACONESS HEALTH COMPENSATION COMMITTEE TO APPROVE EXECUTIVE, DIRECTOR AND PHYSICIAN COMPENSATION AS WELL AS EXECUTIVE AND PHYSICIAN BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS OF DEACONESS HEALTH AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1) ANNUALLY REVIEW AND APPROVE AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE CEO AND EACH OTHER EXECUTIVE OFFICER OF THE SYSTEM ALL ELEMENTS OF EXECUTIVE COMPENSATION 2) MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES 3) OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS 4) REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS 5) RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, CEO OR EXECUTIVE OFFICE COMPENSATION 6) SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS 7) OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS 8) APPROVE ALL PHYSICIAN AND PHYSICIAN RELATED CONTRACTS 9) MAKE REGULAR REPORTS TO THE BOARD |
| FORM 990, PART VI, SECTION C, LINE 19 | METHODIST HEALTH'S ARTICLES OF INCORPORATION ARE ON THE SECRETARY OF STATE'S WEBSITE. METHODIST HEALTH IS PART OF A CONSOLIDATED FINANCIAL STATEMENT WHICH IS AVAILABLE WITH THE PUBLIC DISCLOSURE COPY OF THE IRS FORM 990. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT-OF-INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,147,418. MANAGEMENT AND GENERAL EXPENSES 1,863,333. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,010,751. |
| FORM 990, PART XI, LINE 9: | TRANSFER 7,500,411. |
| FORM 990, PART XII | THE BOARD OF DIRECTORS OF DEACONESS HEALTH, INC. ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE BOARD OF DIRECTORS OF METHODIST HEALTH SHALL TAKE NECESSARY STEPS TO ENSURE IMPLEMENTATION OF AND COMPLIANCE WITH THE RECOMMENDATIONS OF THE DEACONESS BOARD. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DEACONESS CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 263083364 | HEALTHCARE | IN | 501(C)3 | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS GIBSON HOSPITAL | |||||||||||
| 1808 SHERMAN DR | PRINCETON | IN | 47670 | 350877575 | HEALTHCARE | IN | 501(C)3 | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH KENTUCKY INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 830966826 | HEALTHCARE | IN | 501(C)3 | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH SYSTEM INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 351532889 | HEALTHCARE | IN | 501(C)3 | LINE 12A, I | 0 | N/A | |
| DEACONESS HOSPITAL INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 350593390 | HEALTHCARE | IN | 501(C)3 | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS REGIONAL HEALTHCARE SERVICES | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 810693478 | HEALTHCARE | IN | 501(C)3 | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS SPECIALTY PHYSICIANS INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 824503095 | HEALTHCARE | IN | 501(C)3 | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS VNA PLUS LLC | |||||||||||
| 610 E WALNUT ST | EVANSVILLE | IN | 47713 | 465223267 | HEALTHCARE | IN | 501(C)3 | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| HENDERSON REGIONAL HOSPITAL FOUNDATION | |||||||||||
| 1305 NORTH ELM ST | HENDERSON | KY | 42420 | 610944432 | SUPPORT THE HOSPITAL | KY | 501(C)3 | LINE 11 | DEACONESS HEALTH KY | 0 | |
| UNION COUNTY METHODIST HOSPITAL FOUNDATION | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 611230297 | SUPPORT THE HOSPITAL | KY | 501(C)3 | LINE 11 | DEACONESS HEALTH KY | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 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 | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |