MARSHALL COUNTY HOSPITAL DISTRICT: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- MARSHALL COUNTY HOSPITAL DISTRICT (EIN 61-0601267)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202303199349310185
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-15T12:24:51-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621199757 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LBMC PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1869 | AddressLine1Txt |
| City | BRENTWOOD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 370241869 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610601267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY HOSPITAL DISTRICT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARS | BusinessNameControlTxt |
| Phone | 2705274800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID G FUQUA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2705274800 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVID | PersonFirstNm |
| Person Last | FUQUA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MAYUMI STELLA | PreparerPersonNm |
| PTIN | P00970938 | PTIN |
| Phone | 6153774600 | PhoneNum |
| Preparation | 2023-11-14 | 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 | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID G FUQUA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,635,244 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW. MARSHALLCOUNTYHOSPITAL. ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL CARE TO PEOPLE IN MARSHALL AND SURROUNDING COUNTIES | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 339 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,252,092 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,363,922 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,443,335 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,826,892 | CYProgramServiceRevenueAmt |
| PY Investment Income | $116,323 | PYInvestmentIncomeAmt |
| CY Investment Income | $194,388 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,309,513 | PYOtherRevenueAmt |
| CY Other Revenue | $1,248,660 | CYOtherRevenueAmt |
| PY Total Revenue | $28,121,263 | PYTotalRevenueAmt |
| CY Total Revenue | $25,633,862 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,148,065 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,638,339 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,447,887 | PYOtherExpensesAmt |
| CY Other Expenses | $13,662,641 | CYOtherExpensesAmt |
| PY Total Expenses | $26,595,952 | PYTotalExpensesAmt |
| CY Total Expenses | $27,300,980 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,525,311 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,667,118 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $42,667,411 | TotalAssetsBOYAmt |
| Total Assets EOY | $39,357,496 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,467,474 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,003,879 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,199,937 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,353,617 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE MEDICAL CARE TO THE PEOPLE IN MARSHALL AND SURROUNDING COUNTIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,607,912 | ExpenseAmt |
| Revenue | $24,075,552 | RevenueAmt |
| Desc | MARSHALL COUNTY HOSPITAL DISTRICT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO PATIENTS IN MARSHALL COUNTY AND SURROUNDING COUNTIES IN KENTUCKY. IN 2022, THE HOSPITAL HAD 1,103 ACUTE DAYS, 367 ICU DAYS, AND 194 SWING DAYS. | Desc |
| Total Program Service Expenses | $22,607,912 | 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 | 0 | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | 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 | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2705274800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JEFF SMITH | ||||||||
| CHAIRMAN | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BLAKE WISEMAN | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAMELA SIRLS | ||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JERRY SELLS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LAUREN MANN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID G FUQUA | ||||||||
| CEO | 40.00 | 0.00 | $268,518 | $0 | $50,489 | Yes (X) | ||
| JANICE KELLEY | ||||||||
| CFO | 40.00 | 0.00 | $141,372 | $0 | $36,524 | Yes (X) | ||
| TIFFANY N TUBBS | ||||||||
| CCO | 40.00 | 0.00 | $91,486 | $0 | $31,957 | Yes (X) | ||
| BENNIE M FULBRIGHT | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $501,763 | $0 | $40,523 | Yes (X) | ||
| JULIA T LYLES | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $244,204 | $0 | $43,185 | Yes (X) | ||
| CHRISTINA M BROWN | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $240,031 | $0 | $14,399 | Yes (X) | ||
| WILLIAM T POWELL | ||||||||
| PHYSICIAN | 26.00 | 0.00 | $168,909 | $0 | $33,614 | Yes (X) | ||
| DIANE KOLENICH | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $121,170 | $0 | $48,749 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,777,453 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $299,440 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | 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 |
|---|---|---|---|---|---|
| MD PARTNERS PLLC | |||||
| 83 GERALDINE LANE | GILBERTSVILLE | KY | 42044 | ER PHYSICIANS | $1,182,170 |
| EVIDENT DEPT #6448 | |||||
| PO BOX 11407 | BIRMINGHAM | AL | 352466448 | IT SERVICES | $271,227 |
| BRUCE DAVID | |||||
| 272 W 24TH ST | BENTON | KY | 42025 | ANESTHESIOLOGY | $216,667 |
| LEONARD HOHLBEIN | |||||
| 1008 W STATELINE | FULTON | KY | 42041 | ANESTHESIOLOGY | $216,667 |
| AYA HEALTHCARE INC | |||||
| PO BOX 123519 | DALLAS | TX | 753123519 | TRAVEL NURSES & LAB TECHS | $194,938 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $20,245 | RelatedOrganizationsAmt |
| Government Grants | $1,343,677 | GovernmentGrantsAmt |
| Total Contributions | $1,363,922 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621400 | $22,623,564 | $22,623,564 |
| AMBULANCE SERVICES MGT FEES | 621910 | $203,328 | $203,328 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,826,892 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $195,770 | TotalRevenueColumnAmt |
| Exclusion | $195,770 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,382 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,382 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,382 | TotalRevenueColumnAmt |
| Exclusion | -$1,382 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| AD VALOREM TAXES | 900099 | $1,154,791 | $1,154,791 |
| CAFETERIA | 722210 | $89,186 | $89,186 |
| MISC | 900099 | $2,376 | $2,376 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,307 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,307 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,248,660 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,633,862 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,075,552 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $194,388 | 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 | $620,346 | TotalAmt |
| Program Services | $310,173 | ProgramServicesAmt |
| Management And General | $310,173 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,347,414 | TotalAmt |
| Program Services | $9,512,554 | ProgramServicesAmt |
| Management And General | $834,860 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,177 | TotalAmt |
| Program Services | $61,177 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,848,417 | TotalAmt |
| Program Services | $1,690,184 | ProgramServicesAmt |
| Management And General | $158,233 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $760,985 | TotalAmt |
| Program Services | $684,840 | ProgramServicesAmt |
| Management And General | $76,145 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,553 | TotalAmt |
| Management And General | $29,553 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,188 | TotalAmt |
| Management And General | $91,188 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,033,703 | TotalAmt |
| Program Services | $2,809,164 | ProgramServicesAmt |
| Management And General | $224,539 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,368 | TotalAmt |
| Program Services | $78,638 | ProgramServicesAmt |
| Management And General | $6,730 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,820 | TotalAmt |
| Program Services | $173,924 | ProgramServicesAmt |
| Management And General | $102,896 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,876 | TotalAmt |
| Program Services | $584 | ProgramServicesAmt |
| Management And General | $181,292 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $728,644 | TotalAmt |
| Program Services | $258,431 | ProgramServicesAmt |
| Management And General | $470,213 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,810 | TotalAmt |
| Program Services | $12,476 | ProgramServicesAmt |
| Management And General | $2,334 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $794,156 | TotalAmt |
| Program Services | $776,526 | ProgramServicesAmt |
| Management And General | $17,630 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,499,244 | TotalAmt |
| Program Services | $1,457,511 | ProgramServicesAmt |
| Management And General | $41,733 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,079 | TotalAmt |
| Program Services | $453,079 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $2,061,233 | $2,061,233 | |
| COVID COSTS | $1,763,155 | $225 | $1,762,930 |
| REPAIRS & MAINTENANCE | $1,197,481 | $1,166,630 | $30,851 |
| MEDICAL SUPPLIES | $982,004 | $982,004 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,327 | TotalAmt |
| Program Services | $118,559 | ProgramServicesAmt |
| Management And General | $351,768 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,300,980 | TotalAmt |
| Program Services | $22,607,912 | ProgramServicesAmt |
| Management And General | $4,693,068 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,748,021 | BOYAmt |
| EOY | $5,872,402 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,526,943 | BOYAmt |
| EOY | $7,286,041 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,712,804 | BOYAmt |
| EOY | $2,629,264 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $542,540 | BOYAmt |
| EOY | $595,471 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $587,928 | BOYAmt |
| EOY | $336,854 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,154,852 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,594,074 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,496,105 | BOYAmt |
| EOY | $18,560,778 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,890,923 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $53,070 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,070 | BOYAmt |
| EOY | $132,693 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,667,411 | BOYAmt |
| EOY | $39,357,496 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,823,837 | BOYAmt |
| EOY | $2,647,094 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,290,000 | BOYAmt |
| EOY | $16,045,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,000 | BOYAmt |
| EOY | $1,245,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,163,637 | BOYAmt |
| EOY | $66,785 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,467,474 | BOYAmt |
| EOY | $20,003,879 | 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 | $18,199,937 | BOYAmt |
| EOY | $19,353,617 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,199,937 | BOYAmt |
| EOY | $19,353,617 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,667,411 | BOYAmt |
| EOY | $39,357,496 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,667,118 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,820,798 | 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 | $25,312 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $25,312 | 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 HOSPITAL IS A MEMBER OF THE KENTUCKY HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. A PERCENTAGE OF THE MEMBERSHIP DUES PAID TO THESE ORGANIZATIONS ARE USED FOR LOBBYING PURPOSES. THE HOSPITAL PAID DUES OF $25,312 TO THE KENTUCKY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION OF WHICH AN AVERAGE OF 11.9% WAS FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,234,612 | OtherCostOrOtherBasisAmt |
| Book Value | $3,234,612 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,793,775 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,789,625 | DepreciationAmt |
| Book Value | $13,004,150 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,691,732 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,483,795 | DepreciationAmt |
| Book Value | $2,207,937 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,434,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,320,654 | DepreciationAmt |
| Book Value | $114,079 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,560,778 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER LIABILITIES | Desc |
| Amt | $66,785 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $66,785 | 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 | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. MANAGEMENT BELIEVES THEY DO NOT HAVE ANY UNRELATED BUSINESS TAXABLE INCOME. THE FOUNDATION HAS ALSO BEEN RECOGNIZED AS TAX EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3) OF THE IRC. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | $11,074 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,074 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,928,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,343,262 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $585,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02140 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,939,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,343,262 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $596,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02180 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,940,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,343,262 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $597,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02180 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,276,609 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,306,140 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,344,980 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$38,840 | 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 | 0 | 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 | MARSHALL COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | MARSHALL COUNTY HOSPITAL DISTRICT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 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. MARSHALLCOUNTYHOSPITAL. ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW. MARSHALLCOUNTYHOSPITAL. ORG | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW. MARSHALLCOUNTYHOSPITAL. ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW. MARSHALLCOUNTYHOSPITAL. ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, SECTION B, LINE 5: | FormAndLineReferenceDesc |
| Explanation | THE MARSHALL COUNTY HOSPITAL AND THE MARSHALL COUNTY HEALTH DEPARTMENT JOINT-VENTURED AND UTILIZED A COMMUNITY HEALTH ASSESSMENT PROCESS BASED ON MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). MAPP IS A COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS WHICH HELPS COMMUNITIES APPLY STRATEGIC THINKING TO PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES TO ADDRESS THEM. MAPP IS NOT AN AGENCY-FOCUSED ASSESSMENT PROCESS; RATHER, IT IS AN INTERACTIVE PROCESS THAT CAN IMPROVE THE EFFICIENCY, EFFECTIVENESS, AND ULTIMATELY THE PERFORMANCE OF LOCAL PUBLIC HEALTH SYSTEMS. THE ASSESSMENTS USED IN THE MAPP PROCESS INCLUDE COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY STRENGTHS AND RISKS ASSESSMENT, FORCES OF CHANGE ASSESSMENT, AND THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT. THE MARSHALL COUNTY HEALTH DEPARTMENT AUGMENTED THE MAPP PROCESS WITH A THREE PERSPECTIVE APPROACH TO GATHERING INFORMATION. DATA GATHERED IN CONJUNCTION WITH THE COMMUNITY HEALTH STATUS ASSESSMENT PROVIDED A DATA PERSPECTIVE ON THE HEALTH OF EACH COMMUNITY. INFORMATION GATHERED DURING COMMUNITY FORUMS, PRIMARILY ATTENDED BY REPRESENTATIVES OF COMMUNITY PARTNER ORGANIZATIONS, PROVIDED THE ORGANIZATIONAL PERSPECTIVE. IN AN EFFORT TO ADD THE PERSPECTIVE OF INDIVIDUAL CITIZENS OF EACH COUNTY, BOTH PAPER AND ELECTRONIC SURVEYS WERE DISTRIBUTED. INFORMATION FROM THESE SURVEYS PROVIDED THE INDIVIDUAL PERSPECTIVE. IN ADDITION, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT WAS COMPLETED UTILIZING AN ASSET MAPPING APPROACH. THE MARSHALL COUNTY HEALTH COALITION HELD A COMMUNITY FORUM FOR THE PURPOSE OF VISION STATEMENT DISCUSSION, COALITION ACCOMPLISHMENT CELEBRATION AND COMMUNITY HEALTH ASSESSMENT DATA UPDATES. THESE DISCUSSIONS PROVIDED THE FOUNDATION FOR THE 2019-2022 COMMUNITY HEALTH IMPROVEMENT PLAN. AREA BUSINESS LEADERS, COUNTY AND CITY OFFICIALS, LAW ENFORCEMENT, INTERESTED CITIZENS, FAITH-BASED ORGANIZATIONS, HEALTHCARE PROVIDERS AND THE GENERAL PUBLIC WERE INVITED TO PARTICIPATE. IT WAS ARRANGED FOR A FACILITATOR FROM THE UNIVERSITY OF KENTUCKY, DR. ANGIE CARMAN TO LEAD THE GROUP IN DISCUSSING HEALTH CONCERNS FOR MARSHALL COUNTY CITIZENS. MARSHALL COUNTY HOSPITAL DISTRICT: PART V, SECTION B, LINE 6B: THE HOSPITAL PARTNERED WITH MARSHALL COUNTY HEALTH DEPARTMENT TO CONDUCT THE CHNA. SEE ADDITIONAL INFORMATION UNDER LINE 5 ABOVE. MARSHALL COUNTY HOSPITAL DISTRICT: PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY ADOPTION OF AN IMPLEMENTATION STRATEGY THAT ADDRESSES EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, EXECUTION OF THE IMPLEMENTATION STRATEGY, PARTICIPATION IN THE EXECUTION OF A COMMUNITY-WIDE PLAN, ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN THE COMMUNITY, AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN THE COMMUNITY. MARSHALL COUNTY HOSPITAL DISTRICT PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.MARSHALLCOUNTYHOSPITAL.ORG PART V, SECTION B INDIVIDUALS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY ARE NOT CHARGED ANYTHING. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - MARSHALL COUNTY SURGICAL & MEDICAL GRO | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 617 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RURAL HEALTH CLINIC-PROVIDER BASED | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, COMMUNITY BUILDING ACTIVITIES: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION DOES NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT. PART III, LINE 2: THE HOSPITAL HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE HOSPITAL UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. PART III, LINE 3: THE HOSPITAL DOES NOT HAVE BAD DEBT EXPENSES RELATED TO THE PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY.PART III, LINE 4:THE AMOUNTS REPRESENT UNPAID MEDICARE DEDUCTIBLES AND COINSURANCE AND ALL SELF-PAY ACCOUNTS THAT WERE UNPAID. THE HOSPITAL HAS BOTH INTERNAL AND EXTERNAL COLLECTION EFFORTS. BAD DEBT TREATMENT IS COVERED IN FOOTNOTE 4 OF THE FINANCIAL STATEMENTS. 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, LINE 5 REVENUES REPRESENT 101% OF MEDICARE COSTS, LESS 2% SEQUESTRATION, WHICH IS MEDICARE'S REIMBURSEMENT METHODOLOGY FOR CRITICAL ACCESS HOSPITALS, CMS ELIMINATED THE SEQUESTRATION ADJUSTMENT DURING THE COVID PANDEMIC AND IT IS CURRENTLY STILL ELIMINATED THROUGH MARCH 31, 2022. PART III, LINE 9B: AT ADMISSION, ALL PATIENTS WHO DO NOT HAVE INSURANCE COVERAGE FILL OUT A DISPROPORTIONATE SHARE HOSPITAL (DSH) FORM, WHICH IS MAILED BI-WEEKLY TO THE DISABILITY MEDICAL CONSULTANTS (DMC). A PATIENT WHO APPLIES FOR FREE CARE COVERAGE (DSH) OF HIS/HER HOSPITAL SERVICES WILL, UPON REQUEST, RECEIVE A WRITTEN NOTICE OF THE HOSPITAL'S DECISION ON THE REQUEST WITHIN TWO MONTHS OF SUBMISSION OF A COMPLETED APPLICATION AND OTHER REQUIRED INFORMATION. DETERMINATION FOR FREE CARE IS MADE ON AN ACCOUNT BY ACCOUNT BASIS. WITHIN 180 DAYS OF THE DETERMINATION OF THE PATIENT'S INABILITY TO PAY FOR SERVICES, THE HOSPITAL WILL SEND THE PATIENT, HIS/HER GUARANTOR OR OTHER FINANCIALLY RESPONSIBLE PARTY AN INITIAL STATEMENT OF CHARGES CLEARLY STATING THE AMOUNT FOR WHICH THE PATIENT, GUARANTOR OR OTHER FIANCIALLY RESPONSIBLE PARTY IS RESPONSIBLE. AN ITEMIZED BILL WILL BE SENT UPON REQUEST OF THE PATIENT, AND IF NO RESPONSE, A SECOND AND THIRD STATEMENT WILL BE SENT TO THE RESPONSIBLE PARTY. FINALLY, A LETTER IS SENT STATING THAT COLLECTION AGENCY ACTION WILL BE TAKEN. THEREAFTER, IF THE ACCOUNT IS EQUAL TO OR EXCEEDS $1,000, THE HOSPITAL WILL AGAIN INVESTIGATE ALL POTENTIAL PAYMENT SOURCES BEFORE TURNING THE ACCOUNT OVER TO COLLECTIONS. THIS INCLUDES SENDING ANOTHER LETTER THROUGH THE DSH PROGRAM. IF THE AMOUNT IS LESS THAN $1,000 THE HOSPITAL WILL WRITE THE ACCOUNT OFF TO BAO DEBT AND SEND TO A COLLECTION AGENCY. PART VI LINE 2: THE HOSPITAL CONTINUES TO BE PART OF THE MARSHALL COUNTY HEALTH COALITION, MADE UP OF BUSINESS LEADERS, OFFICIALS, LAW ENFORCEMENT, INTERESTED CITIZENS, FAITH-BASED ORGANIZATIONS, AND OTHER HEALTHCARE PROVIDERS, THE COMMITTEE ASSESSES THE NEEDS OF MARSHALL COUNTY RESIDENTS REGARDING HEALTH CARE, SECURITY, AND BOTH ENVIRONMENTAL AND EDUCATIONAL CONCERNS. MARSHALL COUNTY HOSPITAL ASSISTED THE LOCAL HEALTH DEPARTMENT AND OTHER MEMBERS OF THE COALITION IN THE COMPLETION OF THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THE MAPP PROCESS WAS UTILIZED, WITH A THREE-PERSPECTIVE APPROACH TO GATHERING INFORMATION (DATA PERSPECTIVE, ORGANIZATIONAL PERSPECTIVE, AND INDIVIDUAL PERSPECTIVE). COMPLETION OF THE 2022 NEEDS ASSESSMENT RESULTED IN THE MCH COMMUNITY HEALTH NEEDS ASSESSMENT IMPROVEMENT PLAN, ADDRESSING THOSE CONCERNS IDENTIFIED. PART VI, LINE 3: DURING THE ADMISSIONS PROCESS, THE ADMISSIONS CLERK INFORMS ANY PATIENTS WITHOUT INSURANCE COVERAGE ABOUT THE AVAILABLITY OF FREE CARE COVERAGE UNDER THE DISPROPORTIONATE SHARE HOSPITAL PROGRAM (DSH) AND PROVIDES THEM WITH THE FORM TO DETERMINE ELIGIBILTY FOR BOTH THE DSH PROGRAM AND MEDICAID, THE HOSPITAL WILL PROVIDE REASONABLE ASSISTANCE IN COMPLETING THIS FORM, THE HOSPITAL WILL ALSO ADVISE PATIENTS ABOUT ELIGIBILITY FOR AND OBTAINING PUBLIC ASSISTANCE. THE COMPLETED FORM IS MAILED OUT BI-WEEKLY TO DISABILITY MEDICAL CONSULTANTS (DMC), WHO DETERMINE THOSE ELIGIBLE FOR THE DSH PROGRAM, IN ADDITION, THE FINANCIAL COUNSELOR WILL PERSONALLY SPEAK WITH ALL UNINSURED INPATIENTS WHEN FEASIBLE. UPON REQUEST, THE PATIENT WILL RECEIVE WRITTEN NOTICE OF HIS ELIGIBILITY FOR THE DSH PROGRAM WITHIN TWO MONTHS OF SUBMITTING THE COMPLETED APPLICATION AND ANY OTHER REQUIRED INFORMATION. IF THE PATIENT IS A RESIDENT OF KENTUCKY, DOES NOT HAVE HEALTH INSURANCE, MEETS THE INCOME GUIDELINES AND HAS BEEN DENIED MEDICAL CARE BY MEDICAID, THE PATIENT'S BILL WILL BE COVERED UNDER THIS PROGRAM.PART VI, LINE 4: MARSHALL COUNTY, NESTLED ON THE SHORES OF ONE OF THE LARGEST MANMADE LAKES IN THE EASTERN UNITED STATES, HAS AN UNSURPASSED QUALITY OF LIFE. THE SMALL TOWN ATMOSPHERE, COMBINED WITH THE ACCESS TO LARGER METROPOLITAN AREAS, THE LAND BETWEEN THE LAKES NATIONAL RECREATION AREA, THE HIGHLY RATED SCHOOL SYSTEM, AND ABUNDANCE OF JOB OPPORTUNITIES, MAKES THIS AN IDEAL PLACE TO LIVE, WORK AND SUCCEED, MARSHALL COUNTY HAS A POPULATION OF APPROXIMATELY 31,777 PEOPLE WITH A MEDIAN HOUSEHOLD INCOME OF APPROXIMATELY $58,989. PER THE 2022 CENSUS, THE COUNTY IS COMPRISED OF 50.1% FEMALE AND 49.9% MALE AND IS APPROXIMATELY 97.5% CAUCASIAN, THE PERCENTAGE OF INDIVIDUALS LIVING IN POVERTY IS APPROXIMATELY 13.7%. APPROXIMATELY 2% OF THE EMPLOYED POPULATION RECEIVES PUBLIC ASSISTANCE INCOME. APPROXIMATELY 54% OF THE HOSPITAL'S NET PATIENT SERVICE REVENUE IS COMPRISED OF PARTICIPANTS IN MEDICARE AND MEDICAID PROGRAMS. PART VI, LINE 5: MARSHALL COUNTY HOSPITAL IS ACTIVE IN EDUCATING THE COMMUNITY. THE HOSPITAL HAS VISITED SENIOR CITIZENS, RESIDENTS OF THE LOCAL ASSISTED LIVING FACILITY, HOSTED NUMEROUS "LUNCH AND LEARNS" WITH VARIOUS SPEAKERS, AND REPRESENTED THE HOSPITAL AT ALL AREA FAIRS WITH EDUCATIONALINFORMATION, AS WELL AS FREE SCREENINGS TO THE PUBLIC. THE HOSPITAL ALSO PUBLISHES EDUCATIONAL MATERIAL IN THE LOCAL NEWSPAPERS, RADIO, ON-LINE PRODUCTIONS AND THE EMPLOYEE NEWSLETTER.PART VI LINE 6: THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ExplanationTxt |
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 (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BENNIE M FULBRIGHT | ||||||||||||||
| PHYSICIAN | $500,763 | $0 | $1,000 | $0 | $0 | $0 | $17,458 | $0 | $23,065 | $0 | $542,286 | $0 | $0 | $0 |
| DAVID G FUQUA | ||||||||||||||
| CEO | $267,518 | $0 | $1,000 | $0 | $0 | $0 | $26,967 | $0 | $23,522 | $0 | $319,007 | $0 | $0 | $0 |
| JULIA T LYLES | ||||||||||||||
| PHYSICIAN | $235,704 | $0 | $1,000 | $0 | $7,500 | $0 | $20,500 | $0 | $22,685 | $0 | $287,389 | $0 | $0 | $0 |
| CHRISTINA M BROWN | ||||||||||||||
| PHYSICIAN | $239,031 | $0 | $1,000 | $0 | $0 | $0 | $14,399 | $0 | $0 | $0 | $254,430 | $0 | $0 | $0 |
| WILLIAM T POWELL | ||||||||||||||
| PHYSICIAN | $165,742 | $0 | $500 | $0 | $2,667 | $0 | $13,765 | $0 | $19,849 | $0 | $202,523 | $0 | $0 | $0 |
| JANICE KELLEY | ||||||||||||||
| CFO | $140,372 | $0 | $1,000 | $0 | $0 | $0 | $23,244 | $0 | $13,280 | $0 | $177,896 | $0 | $0 | $0 |
| DIANE KOLENICH | ||||||||||||||
| PHYSICIAN | $120,170 | $0 | $1,000 | $0 | $0 | $0 | $20,800 | $0 | $27,949 | $0 | $169,919 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTIAN COUNTY KENTUCKY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 616000824 | BondIssuerEIN |
| CUSIP | 999999999 | CUSIPNum |
| Bond Issued | 2008-04-28 | BondIssuedDt |
| Issue Price | $30,000,000 | IssuePriceAmt |
| Purpose | ACQUISITION, CONSTRUCTION, & | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $12,710,000 | RetiredAmt |
| Total Proceeds | $30,000,000 | TotalProceedsAmt |
| Capitalized Interest | $655,119 | CapitalizedInterestAmt |
| Capital Expenditures | $30,042,765 | CapitalExpendituresAmt |
| Substantial Completion | 2008 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | US BANK NATIONAL AS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 25.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART I, BOND ISSUES: | FormAndLineReferenceDesc |
| Explanation | (A) ISSUER NAME: CHRISTIAN COUNTY KENTUCKY (F) DESCRIPTION OF PURPOSE: ACQUISITION, CONSTRUCTION, & EQUIPPING OF NEW ACUTE CARE HOSPITAL SCHEDULE K ADDENDUM: THE HOSPITAL HAS A LEASE WITH KACO LEASING TRUST AND FILES SCHEDULE K TO PROVIDE COMPLETE REPORTING RELATING TO THIS LEASE. AS A RESULT SOME QUESTIONS APPLICABLE TO BOND COMPLIANCE DO NOT APPLY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | AN OFFICER OF THE BOARD REVIEWS THE 990 ON BEHALF OF THE BOARD OF DIRECTORS BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL PROVIDES THE CONFLICT OF INTEREST POLICY TO THE BOARD AND EMPLOYEES. BOARD MEMBERS FILL OUT THE CONFLICT OF INTEREST POLICY ANNUALLY. THE HOSPITAL'S COMPLIANCE MANUAL HAS A SECTION ON CONFLICTS OF INTEREST AND DEPARTMENT DIRECTORS ARE REQUIRED TO SIGN THAT THEY HAVE READ AND WILL ABIDE BY IT. IF A CONFLICT ARISES, THOSE INVOLVED ARE RECUSED FROM THE DISCUSSION AND ANY VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL PARTICIPATES IN THE KENTUCKY HOSPITAL ASSOCIATION'S SALARY SURVEY IN ORDER TO HAVE ACCESS TO STATE WIDE COMPARABLE SALARY DATA, COMPENSATION IS DOCUMENTED AND APPROVED BY AN INDEPENDENT BODY PRIOR TO SETTING. |
| 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, AT THE DISCRETION OF THE BOARD OF DIRECTORS AND MANAGEMENT. |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,809,164. MANAGEMENT AND GENERAL EXPENSES 224,539. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,033,703. |
| FORM 990, PART XI, LINE 9: | PROVIDER RELIEF FUNDING RECOGNIZED AS REVENUE IN PY, RECLASS FROM LIABILITY 2,820,798. |
| FORM 990, PART XII, LINE 2C | THE HOSPITAL'S BOARD AND SENIOR MANAGEMENT ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY HOSPITAL & HEALTHCARE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611157518 | EIN |
| Primary Activities | SOLICIT CHARITABLE CONTRIBUTIONS FOR THE BENEFIT OF MARSHALL COUNTY KENTUCKY | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY HOSPITAL DISTRICT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY MRI LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 OLD SYMSONIA ROAD | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 465453921 | EIN |
| Primary Activities | L FACILITY | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY HOSPITAL DISTRICT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $42,466 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $537,931 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY HOSPITAL & HEALTHCARE FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $20,245 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |