2022-07-07T17:40:14-05:00 2021-09-30 620713250 KRAFTCPAS PLLC 555 GREAT CIRCLE ROAD NASHVILLE TN 37228 990 2020-10-01 620988604 MACON HOSPITAL INC MACO 6156662147 305 W LOCUST STREET LAFAYETTE TN 37083 SCOTT TONGATE CFO 6156662147 2022-07-07 1 SCOTT TONGATE 999009999 FRANCES E LEAHY P00713593 6152427351 2022-07-06 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z THOMAS KIDD 305 W LOCUST STREET LAFAYETTE TN 37083 20536652 0 X WWW.MCGH.NET X 1975 TN THE MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST. 9 7 246 3 0 0 2668675 3433332 13228460 17004161 9119 13363 93065 85796 15999319 20536652 0 0 0 0 9104232 9870272 0 0 0 6825147 7448154 15929379 17318426 69940 3218226 16354824 17643586 12455721 10526257 3899103 7117329 THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. 0 0 14403358 17008618 TO PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES TO CITIZENS OF MACON COUNTY, TN AND SURROUNDING COUNTIES WITHOUT REGARD TO ABILITY TO PAY, RACE, RELIGION, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, ETC. WE PROVIDE CHRONIC DISEASE MANAGEMENT EDUCATION, COMMUNITY OUTREACH AND HEALTH FAIRS TO OVER 18,874 INDIVIDUALS. PROVIDED $446,873 OF CHARITY CARE FOR YEAR ENDED SEPTEMBER 30, 2021. 14403358 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 74 0 1 246 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TN X SCOTT A TONGATE 6156662147 305 W LOCUST AVE LAFAYETTE TN 37083 X FEMI ODUNUSI M.D./DIRECTOR 2.00 X 1675 0 0 HANNA ILIA M.D./DIRECTOR 2.00 X 3525 0 0 HUGH CLARK DIRECTOR 2.00 X 1200 0 0 RADFORD WEST PRESIDENT 2.00 X X 1100 0 0 STANLEY CHUNN TREASURER 2.00 X X 1200 0 0 LINDA AUSTIN VICE PRESIDENT 2.00 X X 1100 0 0 BARBARA PAINTER DIRECTOR 2.00 X 1100 0 0 MIKE WHITTEMORE DIRECTOR (BEGIN 12/2020) 2.00 X 0 0 0 GLENN HALE DIRECTOR (BEGIN 5/2021) 2.00 X 0 0 0 CHARLIE DARNELL DIRECTOR (END 3/2021) 2.00 X 0 0 0 THOMAS KIDD CEO 50.00 X 0 0 0 SCOTT TONGATE CFO 50.00 X 0 0 0 JENNIFER N FLIPPIN LABORTORY MANAGER 50.00 X 100472 0 3002 111372 0 3002 1 0 0 1 QUORUM HEALTH RESOURCES LLC 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT SERVICES 771242 EMCARE PHYSICIAN SERVICES 7021 COLLECTION CENTER DRIVE CHICAGO IL 60693 PHYSICIAN SERVICES 608711 FISHER HEALTHCARE PO BOX 404705 ATLANTA GA 30384 MEDICAL SUPPLIES 590942 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 63195 ELECTRONIC HEALTH RECORD 453431 CLARK CONSTRUCTION COMPANY INC PO BOX 860689 LAFAYETTE TN 37083 CONSTRUCTION SERVICE 280379 17 3406371 26961 3433332 NET PATIENT SERVICE REVENUE 621110 16968010 16968010 OTHER OPERATING INCOME 621110 36151 36151 17004161 13363 13363 81339 0 81339 81339 81339 ALL OTHER MISC. REVENUE 900099 4457 4457 4457 20536652 17008618 0 94702 X 10900 10900 8079261 7032711 1046550 102126 88113 14013 1125856 941105 184751 552129 506644 45485 240305 240305 18960 200 18760 88956 88956 2172935 1830162 342773 102914 41834 61080 180871 76884 103987 1157915 986968 170947 38494 15755 22739 164028 164028 749224 503672 245552 172563 116007 56556 MEDICAL SUPPLIES 2282275 2252451 29824 MISCELLANEOUS 78714 10852 67862 17318426 14403358 2915068 0 233126 394495 5662772 4927811 1094775 1837850 257284 351539 343166 237486 13085466 4828217 7574795 8257249 1188906 1637156 16354824 17643586 1436141 1615691 5292877 5144693 1697873 1757723 4028830 2008150 12455721 10526257 X 3899103 7117329 0 0 3899103 7117329 16354824 17643586 3218226 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 753 753 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE TENNESSEE HOSPITAL ASSOCIATION ARE FOR LOBBYING. 785487 785487 7217429 2401265 4816164 38930 38930 0 3828794 2091948 1736846 1214826 296074 918752 8257249 DUE FROM THIRD PARTY PAYERS 1545655 OTHER RECEIVABLES 16999 PHYSICIAN GUARANTEE RECEIVABLE 74502 1637156 REFUNDABLE ADVANCES 2008150 2008150 X 20386652 0 20386652 150000 150000 20536652 17318426 0 17318426 0 17318426 PART X, LINE 2: THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE UNITED STATES FEDERAL JURISDICTION. MANAGEMENT PERFORMS AN EVALUATION OF ALL INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HOSPITAL'S INCOME TAX RETURNS TO DETERMINE WHETHER THE INCOME TAX POSITIONS MEET A "MORE LIKELY THAN NOT" STANDARD OF BEING SUSTAINED UNDER EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS PERFORMED ITS EVALUATION OF ALL INCOME TAX POSITIONS TAKEN ON ALL OPEN INCOME TAX RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AND DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2021 OR 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVIDER RELIEF FUNDS 150,000. PART XI LINE 4B THE HOSPITAL MET ALL REQUIREMENTS TO RECOGNIZE THE PROVIDER RELIEF FUNDS RECEIVED AS REVENUE DURING THE CURRENT YEAR. HOWEVER, A RESERVE OF $150,000 WAS RECORDED AS REFUNDABLE ADVANCES ON THE AUDITED FINANCIAL STATEMENTS. THIS AMOUNT IS RECOGNIZED AS REVENUE ON THE CURRENT YEAR 990. 1 1 1 X 1 X 0 1 0 1 1 343372 343372 0.01980 2822388 2707511 114877 0.00660 3165760 2707511 458249 0.02640 3165760 2707511 458249 0.02640 1 2332133 446873 3721673 3986917 -265244 X 1 0 1 1 MACON HOSPITAL INC 305 W LOCUST ST LAFAYETTE TN 37083 WWW.MCGH.NET 0000000080 X X X MACON HOSPITAL INC 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X HTTP://WWW.MCGH.NET/ABOUT-US/ X 1 19 1 HTTP://WWW.MCGH.NET/ABOUT-US/ 0 1 X 200.000000000000 200.000000000000 X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X 1 0 1 0 0 MACON HOSPITAL, INC. PART V, SECTION B, LINE 5: INPUT WAS OBTAINED FROM A LOCAL EXPERT GROUP, WHICH IS AN ADVISORY GROUP OF AT LEAST 15 LOCAL RESIDENTS. THIS GROUP WAS CONSULTED ON FINDINGS FROM SECONDARY DATA GATHERED. THEY ALSO PARTICIPATED IN A SURVEY, WHICH PROVIDED INPUT ON HEALTH NEEDS WITHIN THE COMMUNITY ALONG WITH THOUGHTS ON VULNERABLE POPULATIONS. MACON HOSPITAL, INC. PART V, SECTION B, LINE 11: MACON COUNTY HOSPITAL DETERMINED THE FOLLOWING TO BE THE TOP PRIORITIES TO ADDRESS IN THE COMMUNITY FOR THE NEXT SEVERAL YEARS:- BEHAVIORAL HEALTH WORKING TOWARDS CARE TRANSITION PROGRAM EXPLORE OPTIONS FOR IMPLEMENTING TELEPSYCHIATRY PURSUE PARTNERSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS PROMOTE AND PROVIDE EDUCATIONAL INTERVENTIONS ON BH SUICIDE PREVENTION TRAINING TO HOSPITAL EMPLOYEES PARTICIPATE IN MENTAL HEALTH MONTH EXPLORE IMPLEMENTING MEDICATION MANAGEMENT PROGRAM- AFFORDABILITY INCREASE PROMOTION OF CHARITY CARE, DISCOUNT PROGRAMS AND ASSISTANCE DURING REGISTRATION PROCESS- ACCESSIBILITY RECRUITING ADDITIONAL PHYSICIANS INTO THE COMMUNITY; TARGETING OB/GYN AND INTERNAL MEDICINE PROVIDER CONTINUING EXPANSION OF SPECIALTY CLINIC UPDATING C-ARM IMAGING SCANNER EXPLORE ADDITIONAL TRANSPORTATION OPTIONS-CHRONIC DISEASE MANAGEMENT IMPLEMENTING A CARDIAC REHABILITATION/PULMONARY REHABILITATION GRADUATE PROGRAM BLOOD PRESSURE SCREENINGS AVAILABLE FOR WALK-IN PATIENTS MACON HOSPITAL, INC. PART V, SECTION B, LINE 13B: A COPY OF THE HOSPITAL'S FAP AND FAP APPLICATION FORMS ARE AVAILABLE AT HTTPS://MCGH.NET/FOR-PATIENTS/FINANCIAL-ASSISTANCE-GUIDELINES/. PART I, LINE 7: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. PART II, COMMUNITY BUILDING ACTIVITIES: MACON COMMUNITY HOSPITAL DEDICATED STAFF VOLUNTEERS FOR NUMEROUS CAUSES PROMOTING HEALTH AND WELFARE FOR MACON COUNTY INCLUDING: RELAY FOR LIFE, MAKIN' MACON FIT FITNESS FESTIVAL, MAMMOGRAPHY SCREENINGS, BREAST CANCER AWARENESS EVENTS, SENIOR CITIZENS CENTER EDUCATION AND SCREENINGS, LOCAL RADIO WEEKLY SHOW ON HEALTH ISSUES AND HOW TO TAKE PREVENTATIVE MEASURE, MACON COUNTY CO-ORDINATED SCHOOL HEALTH PROGRAM, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE MACON COUNTY EDUCATION FOUNDATION. PART III, LINE 2: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2021. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE LINE 6. PART III, LINE 9B: THERE ARE NO COLLECTION EFFORTS TAKEN ON THE PATIENTS THAT QUALIFY FOR CHARITY CARE. THEIR ACCOUNTS ARE WRITTEN OFF SO NO MONEY IS OWED AND NO CHARGES ARE RECORDED AS INCOME. PART VI, LINE 2: MACON COMMUNITY HOSPITAL HAS CONDUCTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT AND WE ARE WORKING WITH LOCAL ORGANIZATIONS AND THE COMMUNITY TO IMPLEMENT THE ASSESSMENT. WE ARE ACTIVELY ENGAGED IN PROVIDING FOR AND IMPROVING THE HEALTH OF OUR COMMUNITY. MACON COUNTY, TENNESSEE HAS A STATISTICALLY HIGH PERCENTAGE OF THE POPULATION WITH DIABITIES AND MCH PROVIDES A DIABETES EDUCATION CENTER TO PROVIDE COOKING CLASSES, NUTRITION EDUCATION AND A QUESTION HOTLINE FOR THE COMMUNITY TO MANAGE THEIR DISEASE. MANAGEMENT OF MCH ARE ALSO LEADERS AND ORGANIZERS OF THE ANNUAL MAKIN' MACON FIT FITNESS FESTIVAL THAT PROMOTES AN ACTIVE LIFESTYLE THAT IS IN ITS 27TH YEAR. MCH STAFF WORKS WITH THE MACON COUNTY SCHOOL SYSTEM AND COORDINATED A SCHOOL HEALTH PROGRAM TO PROVIDE CLASSROOM INSTRUCTION ON NUTRITION AND FITNESS TO THE STUDENTS OF THE SCHOOL SYSTEM. MCH STAFF ARE ON THE BOARDS OF THE SENIOR CITIZEN CENTER, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE UPPER MIDDLE TN RURAL HEALTH NETWORK. THROUGH THESE ORGANIZATIONS, WE LEARN OF AND PROVIDER EDUCATION, TRAINING, SCREENINGS AND OTHER ACTIVITIES TO ASSESS AND IMPROVE THE HEALTH NEEDS OF OUR COMMUNITY. PART VI, LINE 3: THE REGISTRATION STAFF DESCRIBE AND PROVIDE LITERATURE ABOUT FINANCIAL ASSISTANCE DURING THE PATIENT INTERVIEW PROCESS. EFFORTS ARE MADE TO PUT PATIENTS IN CONTACT WITH RESOURCES AVAILABLE TO ASSIST THE PATIENT IN GETTING QUALIFIED FOR GOVERNMENT OR OTHER ASSISTANCE. APPLICATIONS FOR HOSPTIAL CHARITY CARE ARE DISTRIBUTED TO REGISTRARS, BILLING OFFICE STAFF AND A SOCIAL WORKER. POSTED NOTICES ARE OTHER SOURCES OF INFORMATION AS WELL AS LINKS ON OUR WEBSITE REGARDING OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE APPLICATION. PART VI, LINE 4: THE POPULATION FOR MACON COUNTY IS ESTIMATED TO BE 25,249.THE MEDIAN HOUSEHOLD INCOME FOR THE AREA IS $35,853, LOWER THAN THAN THE TENNESSEE MEDIAN INCOME OF $53,346.THE PORTION OF THE POPULATION LIVING IN POVERTY IN THE COUNTY IS 16.9%. PART VI, LINE 5: THE MEDICAL STAFF IS OPEN TO ANY PHYSICIAN WHO MEETS CREDENTIALING STANDARDS AND AGREES TO STANDARDS ESTABLISHED BY THE MEDICAL STAFF. VARIOUS LEADERS SERVE ON THE BOARD OF DIRECTORS ALONG WITH LEADERS OF THE PHYSICIAN COMMUNITY. SURPLUS FUNDS PROVIDE CONTINUITY OF HEALTH SERVICES DURING PERIODS OF ECONOMIC DOWNTURN AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. 0 0 0 0 0 0 0 0 0 THOMAS KIDD CEO 0 0 0 0 0 0 0 0 0 0 0 0 SCOTT TONGATE CFO 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE J, PART II THE HOSPITAL CONTRACTS THE SERVICES OF THOMAS KIDD (CEO) AND SCOTT TONGATE (CFO) WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.), AN UNRELATED ORGANIZATION. QHR WAS PAID $365,893 FOR SERVICES PROVIDED BY THESE INDIVIDUALS FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2021. MACON BANK & TRUST SEE PART V 213274 LOANS 0 PAINTER & HUDSON PLLC SEE PART V 207819 PHARMACY SERVICES 0 SCHEDULE L, PART IV MACON COMMUNITY HOSPITAL HAS A BANKING RELATIONSHIP WITH MACON BANK &TRUST. RADFORD WEST IS THE BOARD CHAIR OF MACON COMMUNITY HOSPITAL AND IS ALSO THE PRESIDENT OF MACON BANK & TRUST.THE HOSPITAL HAS A BUILDING LOAN WITH THE BANK WITH A BALANCE OF $212,274 AT 9/30/2021 AND A LINE OF CREDIT WITH A BALANCE OF $1,000 AT 9/30/2021. ALL TRANSACTIONS ARE CONDUCTED ON AN ARM'S LENGTH BASIS.ADDITIONALLY, BARBARA PAINTER IS A CO-OWNER OF THE COMPANY PAINTER & HUDSON, WHICH IS ONE OF THE TOP FIVE HIGHEST COMPENSATED VENDORS. SHE IS A PHARMACIST AND SHE PROVIDES PHARMACY SERVICES FOR THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL CONTRACTS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES WITH QHR (FORMERLY QUOROM HEALTH RESOURCES, INC.). UNDER TERMS OF THE AGREEMENT, QHR PROVIDES THE SERVICES OF A CEO, CFO, AND ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES CONSISTENT WITH THE POLICIES AND DIRECTIVES DICTATED BY THE BOARD OF DIRECTORS. FOR FISCAL YEAR SEPTEMBER 30, 2021 MACON COMMUNITY HOSPITAL PAID QHR $211,268 FOR THE SERVICES OF THOMAS KIDD (CEO), AND $154,625 FOR THE SERVICES OF SCOTT TONGATE (CFO). PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THE CEO AND CFO. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE ITS FORM 990. ONCE THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT, THE FINAL FORM IS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING PRIOR TO FILING. QUESTIONS AND COMMENTS RAISED DURING THE MEETING REGARDING THE FINAL FORM 990 ARE ADDRESSED PRIOR TO FILING. ONCE APPROVED BY THE BOARD, FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES OF THE HOSPITAL ARE COVERED AND REVIEWED BY THE COMPLIANCE OFFICER. ANY EMPLOYEES HAVING A CONFLICT OF INTEREST ARE NOT ALLOWED TO PARTICIPATE IN THE DECISION MAKING REGARDING ANY ACTIVITY THAT WOULD BE VIEWED AS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 IN 2020, QHR CONDUCTED A REVIEW THAT SHOWS THE MINIMUM, MEDIAN, AND MAXIMUM SALARY FOR THE SAME POSITION AT SIMILAR ORGANIZATIONS IN SIZE AND VOLUME. THE BOARD THEN TAKES THIS INFORMATION AND SETS THE SALARY FOR THE CEO AND CFO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE STORED IN ADMINISTRATION AND AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A SEE EXPLANATION IN PART VI AND SCHEDULE J PART III. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,058,248. MANAGEMENT AND GENERAL EXPENSES 341,445. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,399,693. LINENS: PROGRAM SERVICE EXPENSES 73,602. MANAGEMENT AND GENERAL EXPENSES 53. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,655. FEES-PHYSICIANS: PROGRAM SERVICE EXPENSES 698,312. MANAGEMENT AND GENERAL EXPENSES 1,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 699,587. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.