2022-05-02T10:26:09-05:00 2020-06-30 DR-4587-OK BKD LLP 110 N Elgin Ave Suite 400 Tulsa OK 741201490 990 2019-07-01 731235996 Coal County General Hospital % BARBIE MAXWELL COAL 5809272327 PO BOX 326 6 N COVINGTON COALGATE OK 74538 TRENT BOURLAND CEO 5809272327 2022-02-28 true Peter Hollifield P01858194 9185842900 2022-02-15 2019 2022-09-23 18:48:47Z X MARY HURLEY HOSPITAL TRENT BOURLAND PO BOX 326 6 N COVINGTON COALGATE OK 74538 8087194 false X CCGHOSPITAL.COM X 1954 OK TO PROMOTE THE HIGHEST QUALITY HEALTHCARE AT THE MOST AFFORDABLE COST ATTAINABLE 5 5 101 12 0 8644 5707 8920957 8014786 976 -665 1375 63528 8931952 8083356 0 5676 0 0 4002604 4211069 0 0 0 4475246 4334750 8477850 8551495 454102 -468139 5559001 11183600 845638 6938376 4713363 4245224 X COAL COUNTY GENERAL HOSPITAL INC IS A NOT-FOR-PROFIT RURAL HEALTH CARE DELIVERY SYSTEM WHOSE PRIMARY MISSION IS THE CONTINUOUS IMPROVEMENT OF THE HEALTH NEEDS OF THE PEOPLE OF COALGATE AND SURROUNDING COMMUNITIES. WE ARE COMMITTED TO BEING A LEADER IN THE HEALTH SERVICES AND ARE DEDICATED TO IMPROVING EACH AND EVERY LIFE WE TOUCH IN A DYNAMIC MARKETPLACE. WE WORK TOGETHER TO RESPOND QUICKLY WITH INNOVATIVE SOLUTIONS TO DELIVER THE BEST POSSIBLE RESULTS FOR OUTPATIENTS. false false 7449604 5676 8076714 COAL COUNTY GENERAL HOSPITAL IS A 20-BED CRITICAL ACCESS HOSPITAL LOCATED IN COALGATE, OKLAHOMA. THE PRIMARY MISSION IS THE CONTINUOUS IMPROVEMENT OF THE HEALTH NEEDS OF THE PEOPLE OF COALGATE AND SURROUNDING COMMUNITIES. THE HOSPITAL IS COMMITTED TO BEING A LEADER IN HEALTH SERVICES AND IS DEDICATED TO IMPROVING EVERY LIFE TOUCHED. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SINCE THE AUTHORITY DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNT OF CHARGES FOREGONE FOR SERVICES PROVIDED UNDER THE ORGANIZATION'S CHARITY CARE WAS APPROXIMATELY $22,000 FOR THE YEAR ENDED JUNE 30, 2020. TOTAL DIRECT AND INDIRECT COSTS RELATED TO THESE FOREGONE CHARGES WERE APPROXIMATELY $14,000 AT JUNE 30, 2020 BASED ON AN AVERAGE RATIO OF COST TO GROSS CHARGES. IN KEEPING WITH THE COMMITMENT OF CCGH AND ITS AFFILIATES TO SERVE ALL MEMBERS OF ITS COMMUNITY, OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH ITEMS SUCH AS SUBSIDIZED COMMUNITY HEALTH SERVICES, DONATIONS TO OTHER NON-PROFIT HEALTHCARE RELATED PROVIDERS, FINANCIAL SUPPORT TO HEALTHCARE EDUCATIONAL SERVICES AND MANY OTHER COMMUNITY SERVICE ACTIVITIES AND DONATIONS OFFERED THROUGHOUT THE YEAR INCLUDING RELAY FOR LIFE, FFA BOOSTER, BLOOD DRIVES, ATHLETIC BOOSTER SPONSOR, SALVATION ARMY VOLUNTEER, A COMMUNITY CHRISTMAS PARADE AND A COMMUNITY 4TH OF JULY PARADE. 7449604 true false false false false false false false false false true false false true false false false true false false false false false false false false true true false false false false false false false false false true false false false false false false true true false false false true 59 0 true 101 true false false false false false false false false false false false false X 5 5 false false false false true true true true false false false true true true true false true true true false OK X BARBIE MAXWELL 5809272327 PO BOX 326 COALGATE OK 74538 BILLY JOHNSON CEO 40.0 1.0 X 92726 0 7919 TRENT BOURLAND COO 40.0 1.0 X 69452 0 5279 KATHANNE IVEY CHAIR 2.0 0.0 X X 0 0 0 JIM GIRTEN SECRETARY 2.0 2.0 X X 0 0 0 NEAL SERVAIS DIRECTOR 2.0 2.0 X 0 0 0 CHARLES CANIDA DIRECTOR 2.0 2.0 X 0 0 0 PHILLIP HELMS DIRECTOR 2.0 2.0 X 0 0 0 KAY HUNTER CFO 30.0 10.0 X 0 0 0 162178 0 13198 0 false false false DR R J HELTON PO BOX 345 COALGATE OK 74538 MEDICAL DIRECTOR 115000 TOMMIE STANBERRY PO BOX 452 COALGATE OK 74538 ER PHYSICIAN 139435 2 5707 5707 PATIENT & RESIDENT REVENUE 622110 7556551 7556551 SALES TAX REVENUE 900099 458235 458235 8014786 3173 3173 0 0 1600 1600 0 1600 1600 3838 -3838 -3838 -3838 0 0 0 0 0 0 0 0 0 OTHER OPERATING REVENUE 900099 52167 52167 CAFETERIA SALES 900099 6485 6485 PURCHASE DISCOUNTS 900099 2291 2291 985 985 61928 8083356 8076714 935 5676 5676 0 0 0 155457 155457 26053 26053 3419184 2881489 537695 0 313392 300962 12430 296983 285204 11779 0 0 57620 57620 0 0 0 372114 305840 66274 5566 5345 221 1779832 1654422 125410 596 596 0 320848 296107 24741 90161 84146 6015 0 0 25971 25971 0 340332 340332 81977 81977 BAD DEBT EXPENSE 859555 859555 REPAIRS AND MAINTENANCE 201513 190628 10885 FOOD 38263 38263 COVID-19 EXPENSE 30093 28899 1194 130309 120116 10193 8551495 7449604 1101891 0 289652 6871830 59500 42500 0 0 2074476 1855427 0 0 0 0 0 0 310630 268236 74354 28883 3242025 2655035 803637 586990 0 0 0 0 0 0 0 0 1946752 1529734 5559001 11183600 395135 5742314 0 0 0 0 0 0 0 0 0 0 450503 1196062 0 0 0 0 845638 6938376 X 4713363 4245224 0 0 4713363 4245224 5559001 11183600 -468139 X X false true X true false X 73814 37907 35907 3168211 2617128 551083 586990 DUE FROM RELATED PARTY 1206280 SALES TAX RECEIVABLE 58454 EST. THIRD-PARTY PAYOR SETTL. 265000 1529734 7227643 7227643 855713 855713 8083356 7695782 7695782 855713 855713 8551495 Part XI, Line 4b 859,555 of Bad Debt expense net against revenue on audited financial statements; -3,838 of loss included in expenses by audited financial statements; -4 of rounding. Part XII, Line 4b 859,555 of Bad Debt expense net against revenue on audited financial statements; -3,838 of loss included in expenses by audited financial statements; -4 of rounding. PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT INDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true false false 3600 3600 0.00050 388240 121975 266265 0.03460 391840 121975 269865 0.03510 423990 186612 237378 0.03900 423990 186612 237378 0.03900 815830 308587 507243 0.07410 false 859555 155533 2765711 2793368 -27657 X true true 1 1 COAL COUNTY GENERAL HOSPITAL 6 N COVINGTON COALGATE OK 74538 WWW.CCGHOSPITAL.COM 2201 X X X X 3 PROVIDER BASED rural health clinics COAL COUNTY GENERAL HOSPITAL 1 false false true X X X X X X X X X 18 true false false true X www.ccghospital.com X see statement in section C X true 18 true WWW.CCGHOSPITAL.COM false true X 150. 200. X X X X X true true X X X X X true X www.ccghospital.com X www.ccghospital.com X www.ccghospital.com X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 7B OKLAHOMA STATE UNIVERSITY - EXTENSION OFFICE WEBSITE OSURURALHEALTH.BLOGSPOT.COM/P/CHNA.HTML SCHEDULE H, PART V, SECTION B, LINE 11 1) LACK OF MENTAL HEALTH RESOURCES ESPECIALLY FOR A YOUNGER POPULATION (ONGOING FUNDING CUTS) INCLUDING LACK OF AVAILABLE BEDS IN THE AREA. THE HOSPITAL IS WORKING WITH THE LOCAL LPC TO PROVIDE CARE FOR PATIENTS. THIS HAS THE GREATEST IMPACT ON MEDICAID PATIENTS, BUT THROUGH THIS RELATIONSHIP, BOTH ENTITIES ARE EXPLORING FUNDING AND PROVIDER OPPORTUNITIES TO BETTER SERVE THEIR COUNTY. 2) RECRUITMENT OF PROVIDERS- COAL COUNTY IS HOME TO ONE PHYSICIAN WHO IS NEARING RETIREMENT AGE. BASED ON THE NUMBER OF OFFICE VISITS AND COMMITMENTS, FILLING THIS PROVIDER'S ROLE COULD POTENTIALLY NEED TWO OR MORE PROVIDERS TO MEET THE NEEDS OF THE LOCAL POPULATION. THE HOSPITAL IS IN THE PROCESS OF ACQUIRING THREE RHCS WHICH WILL GREATLY ADD TO THE OVERALL PROVIDER BASE. THE HOSPITAL HAS ALSO MET WITH THE OSU RURAL MEDICAL EDUCATION COORDINATOR THAT COVERS SOUTHEAST OKLAHOMA TO SEE ABOUT OPTIONS FOR CLERKSHIPS AND RESIDENCY ROTATIONS. 3) LACK OF TRANSPORTATION- EMS TRANSFERS, TRANSFERS FOR MENTAL HEALTH NEEDS-THIS ISSUE IS FACED BY NOT HAVING ENOUGH STAFF ON DUTY AND THE AVAILABILITY OF A PARAMEDIC FOR THE TRANSFER. AS STATED PREVIOUSLY, THIS HAS BEEN AN ONGOING CONCERN. THE HOSPITAL ADMINISTRATION HAS BEEN DILIGENT TO MEET WITH CITY AND COUNTY LEADERSHIP TO ADDRESS THESE CONCERNS. ALSO, THE HOSPITAL CEO IS A MEMBER OF THE WORKGROUP THROUGH OKLAHOMA HOSPITAL ASSOCIATION TO EXPLORE OPTIONS AND BEST PRACTICES FOR RURAL AREAS. SCHEDULE H, PART V, SECTION B, LINE 15E Coal County General Hospital contacts patients concerned about their bills following discharge by phone and discusses the availablity and eligibility of all programs of assistance. If a patient claims they are unable to pay, the patient is referred to the local Department of Human Services for medical assistance. If denied thru DHS, Hospital personnel offer to help the patient complete the charity care application. Information regarding financial assistance is provided upon admission and included in statements and other literature sent to patients. PART V, SECTION B, LINE 13H Patients whose family income exceeds 150% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of Coal County General Hospital, however, the discounted rates shall not be greater than the amounts generally billed commercially insured patients. There are instances when a patient may appear eligible for charity care discounts, but there is no financial assistance form on file due to a lack of supporting documentation. Often, there is adequate information provided by the patient through other sources, which could provide sufficient evidence to provide the patient with charity care assistance. In the event there is no evidence to support a patient's eligibility for charity care, Coal County General Hospital could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts. Presumptive eligibility may be determined on the basis of individual life circumstances that may include 1) State-funded prescription programs 2) Homeless or received care from a hoclinic 3) Participation in Women, Infants and Children programs (WIC), 4) Food stamp eligibility 5) Subsidized school lunch program eligibility 6) Eligibility for other state or local assistance program there unfunded (e g , Medicaid spenddown) 7) Low income/subsidized housing is provided as a valid address, and 8) Patient is deceased with no known estate. SCHEDULE H, PART V, SECTION B, LINE 5 THE HOSPITAL CEO AND COO PERSONALLY CALLED REPRESENTATIVES FROM THE CITY, COUNTY, COAL COUNTY HEALTH DEPARTMENT, AND LOCAL CIVIC ORGANIZATIONS TO ENCOURAGE THESE INDIVIDUALS TO ATTEND. NOTICES OF COMMUNITY MEETINGS WERE ALSO PLACED ON DOORS, WINDOWS, AND BULLETIN BOARDS OF LOCAL BUSINESSES. SIGNIFICANT EFFORTS WERE MADE TO INCLUDE AND OBTAIN INFORMATION FROM REPRESENTATIVES OF THE LOCAL PUBLIC HEALTH SECTOR, AND COMMUNITY MEMBERS WHO HAD GREAT KNOWLEDGE OF HEALTH CONCERNS FACING LOW-INCOME AND RACIALLY DIVERSE POPULATIONS. PERSONS CONSULTED WERE LOCAL BANKERS, COAL COUNTY HEALTH DEPARTMENT EMPLOYEES, THE COUNTY ASSESSOR, THE COUNTY CLERK, COALGATE PUBLIC SCHOOLS ADMINISTRATION EMPLOYEES AND COAL COUNTY GENERAL HOSPITAL REPRESENTATIVES. 3 HELTON RURAL HEALTH CLINIC 108 W Ohio Coalgate OK 74538 Rural Health Clinic ABC ATOKA MEDICAL CLINIC 1510 S Virginia Ave Atoka OK 74525 RURAL HEALTH CLINIC ABC RURAL HEALTH CLINIC 1011 N Hinckley St Holdenville OK 74848 RURAL HEALTH CLINIC SCHEDULE H, PART VI, LINE 2 Coal County General Hospital assesses the health care needs of the community it serves by consulting with various organizations including but not limited to: Department of Human Services, County Health Department, schools, Extension Service, and churches. To meet 501(r), the Community Health Needs Assessment was completed and made widely available by posting on the Hospital's website. SCHEDULE H, PART VI, LINE 3 Coal County General Hospital has a personal consultation with patients and families concerning availability and eligibility of all programs of assistance. The patients are contacted following discharge by phone and advised of the charity care program and the application is mailed to them. If the patient is unable to be contacted by phone, a statement is sent with an explanation of charity care and an application. We follow up after 30 days by sending a statement and a notice of charity care and request a call or visit. If no response, we continue with our normal collection policy. Notice of our Charity Care program is posted in the Emergency and Admission Departments with contact information. Other available assistance is included and the patient is requested to contact the Department of Human Services for possible assistance. SCHEDULE H, PART VI, LINE 4 Coal County is located in Southeastern Oklahoma. Coalgate is one of the lowest per capita income areas in the state. The community has a very high Medicare and Medicaid population. Persons living below poverty level represent approximately 19.9% of the population. The population is 1,995 and median household income is $32,781. The primary sources of employment are the health center, banks, locally owned businesses, schools, and local, state, and federal government. There is some oil and gas activity in the region. SCHEDULE H, PART VI, LINE 5 The Organization's board is comprised of local citizens from various occupations. The Organization extends privileges to all qualified physicians in the community. All surplus funds, if any, are used to improve equipment for patient care and to increase medical knowledge of staff and citizens. The Hospital operates an emergency room available to all regardless of ability to pay and participates in education and training of healthcare professionals. Part III, Line 3 The amount of bad debt estimated to be attributable to patients under the Organization's charity care policy is determined by using 19.9% of the population in the service area that is under the federal poverty guidel1ne established for charity care. Part I, Line 3C Patients whose family income exceeds 150% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of Coal County General Hospital, however, the discounted rates shall not be greater than the amounts generally billed commercially insured patients. There are instances when a patient may appear eligible for charity care discounts, but there is no financial assistance form on file due to a lack of supporting documentation. Often, there is adequate information provided by the patient through other sources, which could provide sufficient evidence to provide the patient with charity care assistance. In the event there is no evidence to support a patient's eligibility for charity care, Coal County General Hospital could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potentiaL discount amounts. Presumptive eligibility may be determined on the basis of individual life circumstances that may include 1) State-funded prescription programs 2) Homeless or received care from a homeless clinic 3) Participation in Women, Infants and Children programs (WIC) 4 Food stamp eligibility 5) Subsidized school lunch program eligibility 6) Eligibility for other state or local assistance program that are unfunded (eg, Medicaid spenddown) 7) Low income/subsidized housing is provided as a valid address, and 8) Patient is deceased with no known Estate. Part I, Line 7 Charity care was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services on line 7g was determined using the Medicare Cost Report. Part I, Line 7 Col(f) The amount of bad debt expense removed from total expenses to determine the percentage was $859,555. Part III, Line 2 Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 4 The footnote to the organization's financial statements can be found on the attached audited financial statements. Part III, Line 8 The community of Coal County General Hospital has a high Medicare population. Patients with Medicare coverage are accepted at the Hospital regardless of whether or not a surplus or shortfall is realized from providing the services. Providing services to Medicare patients is essential in the community and therefore the Medicare shortfall is considered a community benefit. Total revenue received from Medicare (including DSH and IME) is the gross reimbursement plus settlement (including LSA). Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b Coal County General Hospital has a personal consultation with patients and families concerning availability and eligibility of all programs of assistance. The patients are contacted following discharge by phone and advised of the charity care program and the application is mailed to them. If a patient claims they are unable to pay, the patient is referred to the local Department of Human Services for medical assistance. If denied thru DHS, Hospital personnel offer to help the patient complete the charity care application. If necessary, the patient is granted additional time to complete the application. Upon completing the application, the account is reviewed. When a decision is made on acceptance of charity care, the patient is contacted and advised of acceptance. If the application is rejected, the patient is contacted and an explanation given. If the patient is unable to be contacted by phone, a statement is sent with an explanation of charity care and an application. We follow up after 30 days by sending a statement and a notice of charity care and request a call or visit. If no response, we continue with our normal collection policy. There is a waiting period of 120 days from the date a statement would be forwarded to collections. Patients are allowed to complete the application for financial assistance for an additional 120 days. The application would be processed and if found to qualify, they would be removed from collections. Nancy Johnson spouse of CEO 26053 Employee compensation and ben. false FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. THE CEO AND CFO REVIEW THE 990. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY DISCLOSURE IS MADE BY EACH INDIVIDUAL OF POSSIBLE CONFLICTS AND IS REVIEWED BY THE BOARD. THE BOARD DETERMINES WHETHER A CONFLICT EXISTS. ANY PERSON WITH ACTIVITY DEEMED A CONFLICT OF INTEREST IS REQUIRED TO CEASE AND DESIST OR RESIGN. FORM 990, PART VI, SECTION B, LINE 15A ALL COMPENSATION FOR MANAGEMENT IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. OHA DATA, AS WELL AS PREVAILING RATES IN THE AREA, ARE USED TO DETERMINE PROPER COMPENSATION. THE DELIBERATION AND DECISIONS ARE DOCUMENTED IN PERSONNEL FILES AND BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. HOWEVER, WITH WRITTEN REQUEST TO THE BOARD THESE DOCUMENTS CAN BE REVIEWED. Form 990, Part XII, Line 2c The Organization's Board of Directors assumes responsibility for oversight of the audit of its financial statements and selection of an independent accountant. Form 990, Part VI, Section A, line 6 The sole member of the Corporation is Coal County General Hospital Holding Company. Form 990, Part VI, Section A, Line 7a The Member elects the Directors at its annual meeting by ballot from a list of qualified persons whose names are submitted as nominees by the Nominating Committee of the Member. Form 990, Part VI, Section A, line 7b The Member, acting by and through its Board of Directors, shall vote, furnish any necessary consent or approval, or take other action on any issue that may properly be presented to the Member. Notwithstanding the above, however, the following matters must receive approval of the Membership of the Member (a) the amendment, restatement or repeal of the Certificate of Incorporation of the Corporation, (b) the amendment, restatement or repeal of these Bylaws to the extent the rights or obligations of the Member or its Membership are affected thereby (c) the election of the directors of the Corporation, (d) the merger, consolidation or disposition of all or substantially all of the assets of the Corporation, (e) the dissolution, liquidation or termination of the business of the Corporation, (f) a material change in the purposes for which the Corporation was formed, and (g) the filing of a voluntary petition under any law having for its purpose the adjudication of the Corporation as bankrupt or insolvent or the taking of any action with respect to the reorganization or liquidation of the Corporation. Amended Return The original return was filed prior to audit being completed. This return is being filed to reflect the audited financial statements, which are attached with this return. Items that changed as a result of the audited financial statements include: Balance Sheet, Income Statement, Supplemental Schedules, Compensation of Officers. COAL COUNTY GENERAL HOLDING CO PO BOX 326 COALGATE OK 74538 680632558 HEALTHCARE OK 501(C)(3) 12C, III-FI NA false COAL COUNTY EXTENDED CARE INC PO BOX 326 COALGATE OK 74538 680632560 NURSING HOME OK 501(C)(3) 10 COAL CTY GHC true false false false true false false false false false false false false false true true false false false false