2025-07-30T07:29:41-05:00 2024-09-30 351178661 BLUE & CO LLC 2650 EASTPOINT PKWY SUITE 300 LOUISVILLE KY 40223 990 2023-10-01 810893103 TJ HEALTH COLUMBIA INC TJHE 2706514157 1301 N RACE STREET GLASGOW KY 42141 MEI DENG CFO 2706514157 2025-07-29 1 1 EMILIE M KNIERIEM CPA P01330194 5029923500 2025-07-29 2023 2025-03-06 01:10:19Z MEI DENG 1301 NORTH RACE STREET GLASGOW KY 42141 22039824 0 X WWW.TJREGIONALHEALTH.ORG X 2015 KY T.J. HEALTH COLUMBIA WILL PROMOTE AND PROVIDE FOR THE HEALTH AND WELLNESS OF THE COMMUNITIES WE SERVE AND THE HEALTHCARE PROFESSIONALS WHO SERVE THEM. 10 9 170 9 0 0 0 130770 19702253 21840888 3281 7025 59366 61141 19764900 22039824 235451 0 0 0 10272661 11909114 0 0 0 5830031 5948800 16338143 17857914 3426757 4181910 17024365 21068368 935560 797653 16088805 20270715 X T.J. HEALTH COLUMBIA WILL PROMOTE AND PROVIDE FOR THE HEALTH AND WELLNESS OF THE COMMUNITIES WE SERVE AND THE HEALTHCARE PROFESSIONALS WHO SERVE THEM. THE PAST, PRESENT, AND FUTURE ACTIVITIES OF T. J. HEALTH COLUMBIA INCLUDE ESTABLISHING AND OPERATING A MEDICAL CENTER TO PROVIDE INPATIENT AND OUTPATIENT HOSPITAL AND ANCILLARY HEALTH CARE SERVICES TO THE COMMUNITY OF COLUMBIA, KENTUCKY, ADAIR COUNTY AND THE SOUTH-CENTRAL REGION OF KENTUCKY, REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. 0 0 14073605 21840888 T.J. HEALTH COLUMBIA PROVIDES HEALTHCARE SERVICES TO ADAIR AND SURROUNDING COUNTIES IN KENTUCKY. 1,494 ACUTE HOSPITAL AND EMERGENCY ROOM CARE PATIENT DAYS AND 8,363 ER VISITS IN FYE 9/30/24. 14073605 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 170 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 KY X THE ORGANIZATION 2706514157 1301 N RACE STREET GLASGOW KY 42141 T RICH ALEXANDER CHAIRMAN 1.00 3.00 X X 0 0 0 BRENT BILLINGSLEY VICE CHAIRMAN 1.00 3.00 X X 0 0 0 ERVIN SORRELL TREASURER 1.00 2.00 X X 0 0 0 MICHAEL SCOTT YOUNG SECRETARY 1.00 3.00 X X 0 0 0 JOEY ALLEN BOTTS DIRECTOR 1.00 3.00 X 0 0 0 HENRY ROYSE DIRECTOR 1.00 4.00 X 0 16825 0 BO MATTHEWS DIRECTOR 1.00 2.00 X 0 0 0 DAN FOUTCH DIRECTOR 1.00 3.00 X 0 0 0 KYLE KISER MD DIRECTOR/VICE CHIEF OF STAFF (END 12/23) 1.00 41.00 X 0 0 0 MICHAEL SARIDAKIS MD DIRECTOR/CHIEF OF STAFF (END 12/23) 1.00 41.00 X 0 489339 38687 AMY NORRIS CASSADY DIRECTOR 1.00 2.00 X 0 0 0 CORNELIUS FAULKNER DIRECTOR 1.00 2.00 X 0 0 0 NEIL THORNBURY CEO 5.00 46.00 X 0 584673 60907 MEI DENG CFO 5.00 46.00 X 0 367762 30840 CLINTON KITECK PHYSICIAN 40.00 0.00 X 312712 0 36287 PATRICIA DOOLIN NURSE PRACTITIONER 40.00 0.00 X 205564 0 14056 ASHLEY MATNEY NURSE PRACTITIONER 40.00 0.00 X 331909 0 25496 EMILY JESSIE NURSE PRACTITIONER 40.00 0.00 X 184539 0 19226 TERESA SHEFFIELD NURSE PRACTITIONER 40.00 0.00 X 183842 0 5214 JOHN CRADDOCK FORMER VICE CHIEF OF STAFF 1.00 41.00 X 0 612646 38687 ERIC FISHER FORMER CHIEF OF STAFF 1.00 41.00 X 0 359113 36940 1218566 2430358 306340 15 1 1 0 SE EMERGENCY PHYSICIANS LLC PO BOX 634850 CINCINNATI OH 45263 ER/URGENT CARE CONTRACTED PHYSICIANS 1025840 HOSPITAL MEDICINE ASSOCIATES LLC PO BOX 634850 CINCINNATI OH 45263 CONTRACTED PHYSICIANS 444471 ALLIANCE HEALTHCARE SERVICE INC PO BOX 735714 DALLAS TX 75373 RADIOLOGY SERVICES 201268 3 130770 130770 NET PATIENT REVENUE 621999 20541899 20541899 340B PHARMACY REVENUE 621399 1298989 1298989 21840888 7025 7025 REV SHARE COMMERCE BANK 900099 2241 2241 PHOTO COPY REVENUE 900099 2043 2043 PURCHASE DISCOUNTS 900099 1090 1090 55767 55767 61141 22039824 21840888 0 68166 X 9586555 7477513 2109042 288931 225366 63565 1367002 1066262 300740 666626 519968 146658 2922418 2480811 441607 401126 160450 240676 74100 66690 7410 600647 378408 222239 27080 10832 16248 10783 4313 6470 59 24 35 476762 333733 143029 49257 44331 4926 MEDICAL SUPPLIES & DRUG 889620 889620 PROVIDER TAX 248737 248737 REPAIRS & MAINTENANCE 181791 139979 41812 DUES AND SUBSCRIPTIONS 30582 12233 18349 35838 14335 21503 17857914 14073605 3784309 0 9180 10213 2276272 1323721 1862901 1883454 384 0 269230 405198 42189 63452 8680899 3687977 2771607 4992922 9792602 12389408 17024365 21068368 839537 797653 96023 0 935560 797653 X 16088805 20270715 16088805 20270715 17024365 21068368 4181910 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1054 1054 0 PART II-B, LINE 1: THE HOSPITAL PAYS MEMBERSHIP DUES TO THE KENTUCKY HOSPITAL ASSOCIATION OF WHICH A PORTION OF THE DUES ARE USED FOR LOBBYING PURPOSES. 667576 667576 5695893 2360552 3335341 2249515 1323511 926004 67915 3914 64001 4992922 DUE FROM RELATED ENTITY 12021394 ESTIMATED THIRD PARTY SETTLEMENT 368014 12389408 X PART X, LINE 2: TJ SAMSON COMMUNITY HOSPITAL (TJS), TJ HEALTH COLUMBIA (TJHC), AND TJ REGIONAL HEALTH (TJR) ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS SUCH, TJS, TJHC, AND TJR ARE GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THEY ARE REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. TJ HEALTH PARTNERS (TJHP) IS AN LLC, AND IS TREATED AS A PARTNERSHIP FOR INCOME TAX PURPOSES. THE LLC'S NET EARNINGS OR LOSSES ARE ALLOCATED TO ITS SOLE OWNER (TJR) AND INCLUDED IN THE OWNER'S INCOME TAX RETURN. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 X 1 X 1 X 1 1 1 0 1 1 53355 53355 0.00300 1 6480710 9565428 0 0.00000 1 6534065 9565428 53355 0.00300 7 2072 5300 5300 0.00030 514 7010 8965 8965 0.00050 521 9082 14265 14265 0.00080 522 9082 6548330 9565428 67620 0.00380 4 3060 439 439 0.00000 4 3060 439 439 0.00000 1 1114425 0 2396220 3597946 -1201726 X 1 1 1 1 TJ HEALTH COLUMBIA 901 WESTLAKE DRIVE COLUMBIA KY 42728 WWW.TJREGIONALHEALTH.ORG 10001 X X TJ HEALTH COLUMBIA 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X HTTPS://WWW.TJREGIONALHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT/ X X 1 21 1 HTTPS://WWW.TJREGIONALHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT/ 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X 1 X SEE PAGE 8 PART V SECTION B LINE 16J X SEE PAGE 8 PART V SECTION B LINE 16J X SEE PAGE 8 PART V SECTION B LINE 16J X X X X X X X 1 X 0 X X X X 1 X 0 0 T.J. HEALTH COLUMBIA PART V, SECTION B, LINE 5: COUNTY ASSESSMENT TEAMS FROM THE DIFFERENT COUNTIES THE HOSPITAL SERVES WERE CREATED TO HELP DISTRIBUTE AND COLLECT COMMUNITY-WIDE SURVEYS AND CONDUCT KEY INFORMANT INTERVIEWS. KEY INFORMANT INTERVIEWS WERE BROKEN UP INTO THREE GROUPS: GROUP A-AFFECTED PEOPLE, GROUP B-POLICY-MAKERS, AND GROUP C-PROVIDERS. GROUP A-AFFECTED PEOPLE INCLUDED INDIVIDUALS DIRECTLY RELATED TO ONE OF THE PRIORITY HEALTH ISSUES. GROUP B-POLICY MAKERS INCLUDED INDIVIDUALS WHO MUST MAKE LEADERSHIP DECISIONS THAT AFFECT THE PRIORITY HEALTH ISSUES AND INCLUDED ELECTED OFFICIALS, HUMAN RESOURCE DIRECTORS, SCHOOL SYSTEM SUPERINTENDENTS, AND LOCAL GOVERNMENT OFFICALS. GROUP C-PROVIDERS INCLUDED HEALTH CARE PROVIDERS SUCH AS PHYSICIANS, SCHOOL NURSES, NUTRITIONISTS, AND HEALTH EDUCATORS. T.J. HEALTH COLUMBIA PART V, SECTION B, LINE 6A: TJ SAMSON COMMUNITY HOSPITAL T.J. HEALTH COLUMBIA PART V, SECTION B, LINE 7D: SOCIAL MEDIA T.J. HEALTH COLUMBIA PART V, SECTION B, LINE 11: T.J. HEALTH COLUMBIA, IN RESPONSE TO THE ASSESSMENT AND PRIORITY HEALTH ISSUE FINDINGS, HAS USED THE DATA COLLECTED TO IDENTIFY AREAS OF OPPORTUNITY TO BETTER MEET THE HEALTH NEEDS THAT IMPACT THE HOSPITAL'S PATIENT POPULATION. THE COMMUNITY HEALTH NEED ASSESSMENT IN PLACE HAS GUIDED THIS ORGANIZATION IN DECISIONS MADE REGARDING PROGRAM IMPLEMENTATION AND PROMOTION, DISEASE MANAGEMENT, COMMUNITY PARTNERSHIPS, AND HEALTH AND AWARENESS CAMPAIGNS ESTABLISHED OVER THE PAST YEARS. THE PRIORITY HEALTH ISSUES IDENTIFIED FOR TJHC SERVICES AREAS ARE CHRONIC DISEASE PREVENTION, PHYSICAL ACTIVITY, OBESITY, HEALTH LIVING, AND SUBSTANCE ABUSE. TO PROVIDE MORE FOCUS TJ HEALTH COLUMBIA HAS BROKEN DOWN THE PRIORITIES HEALTH AND FOCUSED AROUND OBESITY, DIABETES, CARDIOVASCULAR, DRUG & ALCOHOL ABUSE AND ADDICTION AND LUNG CANCER. TJHC OFFERS AND HOST MANY COMMUNITY FUNCTIONS THROUGHOUT THE YEAR TO PATIENTS IN THE COMMUNITY. THE COMMUNITY HEALTH FAIRS ARE THE LARGEST AND MOST WELL ATTENDED EVENTS THAT ARE OFFERED THROUGHOUT THE YEAR.OBESITY, DIABETES, AND CARDIOVASCULAR DISEASE: WHEN ADDRESSING OBESITY IN OUR COMMUNITIES TJ HEALTH COLUMBIA HOLDS AN ANNUAL HEALTH COMMUNITY HEALTH FAIR IN COLUMBIA AND GLASGOW SERVING OVER 600 PATIENTS WITH DIRECT CARE SERVES FOR BOTH EVENTS COMBINED. THE COLUMBIA HEALTH FAIR INCLUDED FIVE PRE-DRAW DAYS AND A SATURDAY HEALTH FAIR DAY FOR COMMUNITY MEMBERS TO PICK UP THEIR RESULTS AND HAVE THEM REVIEWED BY TJ HEALTH COLUMBIA PROVIDERS. T.J. HEALTH FAIRS OFFERED A WIDE VARIETY OF EARLY DETECTION INFORMATION, EDUCATIONAL BOOTHS, AND PREVENTIVE HEALTH SCREENINGS. PREVENTIVE SCREENINGS INCLUDE: BASIC LAB PANEL, LIPID PANEL, HEIGHT/WEIGHT/BMI, BLOOD PRESSURE, NUTRITION COUNSELING, FLU SHOTS, BONE DENSITY SCREENINGS AND MORE. T.J. ALSO OFFERS FREE SPORT PHYSICALS FOR STUDENTS IN GRADES 6 THROUGH 12. THIS YEAR WE ALSO DISPENSED ALMOST $30,000 WORTH OF FREE FLU, COVID, SHINGLES, AND PNEUMONIA VACCINES.T.J. SAMSON COMMUNITY HOSPITAL OFFERED MONTHLY LUNCH AND LEARN EVENTS THAT PROVIDE HEALTH INFORMATION TO STAFF AND THE GENERAL PUBLIC CONCERNING CURRENT HEALTH TOPICS FACING THE COMMUNITY. THE PRESENTATIONS SPECIFICALLY ARE FOCUSED ON NUTRITION, PHYSICAL ACTIVITY, AND LIFESTYLE. THE LUNCH & LEARN EVENTS ARE HELD IN BOTH GLASGOW AND COLUMBIA LOCATIONS.T.J. SAMSON COMMUNITY HOSPITAL OFFERED MONTHLY BARIATRIC SUPPORT GROUPS AND SEMINARS. TJ REGIONAL HEALTH IS WORKING ON EXTENDED THESE SERVICES TO THE COLUMBIA AREA. T.J. HEALTH COLUMBIA PART V, SECTION B, LINE 16J: HTTPS://WWW.TJREGIONALHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-PRICING/FINANCIAL-ASSISTANCE/ 7 1 - COLUMBIA CLINIC 902 WESTLAKE DRIVE COLUMBIA KY 42728 PRIMARY CARE 2 - COLUMBIA PRIMARY CARE CLINIC 810 JAMESTOWN STREET COLUMBIA KY 42728 PRIMARY CARE 3 - EDMONTON CLINIC 1704 W STOCKTON STREET EDMONTON KY 42129 PRIMARY CARE 4 - RUSSELL SPRINGS CLINIC 542 STEVE DRIVE RUSSELL SPRINGS KY 42642 PRIMARY CARE 5 - GREENSBURG CLINIC 603 COLUMBIA HIGHWAY GREENSBURG KY 42743 PRIMARY CARE 6 - SCOTTSVILLE CLINIC 1084 VETERANS MEMORIAL HIGHWAY SCOTTSVILLE KY 42164 PRIMARY CARE 7 - TOMPKINSVILLE CLINIC 800 N MAIN STREET TOMPKINSVILLE KY 42167 PRIMARY CARE PART I, LINE 3C: TJ HEALTH COLUMBIA, INC.'S FINANCIAL ASSISTANCE POLICY USES THE FOLLOWING ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IN ADDITION TO THE FPG: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. PART I, LINE 7: TJ HEALTH COLUMBIA, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS USING THE COST-TO-CHARGE RATIO DERIVED FROM IRS WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. SCHEDULE H, PART I, LINE 7 IN 2019, THE HOSPITAL HAS BEEN PARTICIPATING IN THE MEDICAID HOSPITAL RATE IMPROVEMENT PROGRAM ("HRIP"). THIS PROGRAM WAS DESIGNED TO PROVIDE SUPPLEMENTAL MEDICAID PAYMENTS TO CERTAIN KENTUCKY HOSPITALS TO COVER THE GAP BETWEEN REGULAR INPATIENT MEDICAID PAYMENTS AND MEDICARE ALLOWABLE COSTS. EFFECTIVE JULY 1, 2020, THE PROGRAM WAS MODIFIED TO PROVIDE SUPPLEMENTAL MEDICAID PAYMENTS TO CERTAIN KENTUCKY HOSPITALS TO COVER THE GAP BETWEEN INPATIENT MEDICAID PAYMENTS AND THE AVERAGE COMMERCIAL PAYMENT RATE. THE AMOUNT HOSPITALS RECEIVE IS DETERMINED ANNUALLY PRIOR TO EACH STATE FISCAL YEAR. THE PAYMENTS ARE MADE EACH QUARTER, AND THEY ARE BASED ON PAID CLAIMS, WITH THE STATE MATCHING FUNDS COMING FROM A NEW ASSESSMENT ON HOSPITALS EVERY QUARTER. PART II, COMMUNITY BUILDING ACTIVITIES: T.J. HEALTH COLUMBIA'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY THE ORGANIZATION SERVES BY OFFERING THE FOLLOWING:- HEALTH FAIR- KIDS SAFETY DAY- TJ HEALTH COLUMBIA COMMUNITY HEALTH NEEDS PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE VALUE. THE HOSPITAL MAINTAINS ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS AND FOR ESTIMATED LOSSES RESULTING FROM A PAYOR'S INABILITY TO PAY. MANAGEMENT ESTIMATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON THEIR ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL AND CURRENT BUSINESS AND ECONOMIC FACTORS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. PART III, LINE 3: THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON, THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 4: THE FOOTNOTE EXPLANATION FOR BAD DEBT EXPENSE IS ON PAGES 8-10 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE (SHORTFALL)/SURPLUS WAS CALCULATED BASED ON THE FILED 9/30/24 COST REPORT. PART III, LINE 9B: THE HOSPITAL PROVIDES ASSISTANCE TO PATIENTS THAT QUALIFY UNDER THE GUIDELINES. PART VI, LINE 2: T.J. HEALTH COLUMBIA (TJHC) HAS AN ORGANIZATIONAL COMMITMENT TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES THAT WE SERVE. THE HEALTH NEEDS OF OUR COMMUNITY ARE ASSESSED IN A NUMBER OF WAYS. QUARTERLY MARKET SHARE REPORTS ARE UTILIZED TO IDENTIFY INPATIENT AND OUTPATIENT TRENDS AND MIGRATION OF PATIENTS. THIS METHOD IS USED TO IDENTIFY SERVICES THAT ARE CURRENTLY NEEDED OR IN HIGH DEMAND FOR EXPANSION. IN ADDITION, BY STUDYING COMMUNITY HEALTH REPORTING CONDUCTED BY IOWA DEPARTMENT OF PUBLIC HEALTH, WE ARE ABLE TO IDENTIFY AREAS THAT NEED TO BE ADDRESSES WITHIN OUR COMMUNITY. CURRENTLY, PLANS ARE DEVELOPED UTILIZING HOSPITAL COMMUNITY HEALTH EDUCATORS TO SCREEN AND EDUCATE THE COMMUNITY AND TARGET THOSE SPECIFIC DEMOGRAPHICS IN NEED. A DEDICATED LOCATION IN THE COMMUNITY HAS BEEN DESIGNATED TO HOUSE THE EDUCATORS. IT WAS DETERMINED THAT A SEPARATE LOCATION AWAY FROM THE HOSPITAL WAS APPEALING TO OUR CONSUMERS AND ALLOWED THE COMMUNITY EDUCATORS PLENTY OF SPACE TO PROVIDE SERVICES. OUR COMMUNITY HEALTH EDUCATORS PARTNER WITH LOCAL BUSINESSES AND INDUSTRIES TO CONDUCT HEALTH EVENTS. SOME EXAMPLES OF SERVICES PROVIDED TO THE COMMUNITY ARE HEALTH FAIRS, PROSTATE SCREENINGS, GLUCOSE CHECKS, CPR, CHOLESTEROL TESTS, BLOOD PRESSURE SCREENINGS, BMI CHECKS, CANCER SUPPORT, DIABETIC SUPPORT, BEREAVEMENT SUPPORT, CHILDBIRTH CLASSES, CHILD SAFETY SEAT TRAINING, AND COMMUNITY SUPPORT GROUPS. TJHC PROUDLY SPONSORS EVENTS CONDUCTED BY AREA SCHOOL SYSTEMS. OUR VISION IS TO INVEST IN THE YOUTH BY PROVIDING INFORMATION AND EDUCATION AT AN EARLY AGE CAUSING STUDENTS TO BE PROACTIVE ABOUT THEIR HEALTH. EXAMPLES OF EVENTS INCLUDE SPORTS BOWLS, CAREER FAIRS, AND SCHOOL HEALTH EVENTS. THE HOSPITAL ALSO UTILIZES COMMUNITY MEMBERS TO FORM THE PATIENT ADVISORY COUNCIL TO WORK AS A SOUNDING BOARD FOR NEW AND EXPANDING SERVICES AS WELL AS TO IDENTIFY PATIENT EXPERIENCES THAT NEED IMPROVEMENT. ANNUALLY, T.J. HEALTH COLUMBIA WORKS THROUGH STRATEGIC PLANNING AND CONSUMER PREFERENCE DATA (AN ONLINE SERVICING TOOL) TO HELP IDENTIFY AND PRIORITIZE SERVICES THAT NEED TO BE IMPROVED OR CREATED IN ORDER TO BETTER MEET THE HEALTH NEEDS OF THE COMMUNITY. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: T.J. HEALTH COLUMBIA INFORMS EACH PERSON BILLED FOR SERVICES ON THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, AND LOCAL GOVERNMENT. UPON ADMISSION EACH PATIENT IS PROVIDED WITH A PACKET THAT INCLUDES A BROCHURE THAT IS A GUIDE TO THEIR HOSPITAL BILL. THIS GUIDE EDUCATES THAT PATIENT ON INSURANCE BILLING INFORMATION AS WELL AS PAYMENT ARRANGEMENTS OFFERED BY THE HOSPITAL. OPTIONS INCLUDE A DISPROPORTIONATE SHARE HOSPITAL PROGRAM (DSH), FIRST SOURCE WHICH PROVIDES INFORMATION AND EDUCATION ON FEDERAL ASSISTANCE PROGRAMS, CHARITY AND FINANCIAL AID ASSISTANCE APPLICATIONS, AND PAYMENT SCHEDULE ARRANGEMENTS. PART VI, LINE 4: TJ HEALTH COLUMBIA IS LOCATED IN COLUMBIA, KENTUCKY, WHICH IS THE COUNTY SEAT OF ADAIR COUNTY. ADAIR COUNTY IS LOCATED IN THE HEART OF SOUTH-CENTRAL KENTUCKY AND HAS A POPULATION OF OVER 19,000. ADAIR COUNTY IS KNOWN FOR ITS IDEAL LOCATION BETWEEN GREEN RIVER RESERVOIR, DALE HALLOW LAKE STATE PARK, BARREN RIVER STATE PARK, AND LAKE CUMBERLAND STATE PARK. TJ HEALTH COLUMBIA SIX-COUNTY SERVICE AREA OF APPROXIMATELY 2,000 SQUARE MILES EXTENDS BEYOND THE HEALTH CARE SERVICES TO OVER 129,000 RESIDENTS. TJ HEALTH COLUMBIA DEFINES ITS PRIMARY SERVICE AREA BASED ON THE LOCATION OF WHERE THE MAJORITY OF OUR INPATIENTS RESIDE. TJHC PRIMARY SERVICE AREAS ARE ADAIR AND METCALFE COUNTIES. THE SECONDARY SERVICE AREAS ARE BARREN, GREEN COUNTY, TAYLOR, AND RUSSELL COUNTIES. THE PERCENT OF PERSONS IN POVERTY FOR TJHC'S PRIMARY AND SECONDARY SERVICE AREAS RANGED FROM 15.9%-22.6% WITH 6 OF THE 6 COUNTIES BEING ABOVE THE STATE AVERAGE OF 16.5%. WHEN LOOKING AT THE INCOME PER CAPITA, THE AVERAGE MEDIAN INCOME FOR THE TJHC SERVICES AREAS WAS $22,813 WHICH IS WELL UNDER STATE AVERAGE OF $29,123. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH OUR MISSION: TJHC WILL PROMOTE AND PROVIDE FOR THE HEALTH AND WELL BEING OF THOSE WE SERVE. OUR VISION: AS A REGIONAL PROVIDER, TJHC TAKES PRIDE IN BEING GOOD STEWARDS OF OUR AVAILABLE RESOURCES AND UTILIZING THEM TO ANTICIPATE AND EXCEED THE HEALTH NEEDS OF THE REGION BY PROMOTING HEALTH IN OUR COMMUNITIES AND DELIVERING QUALITY, APPROPRIATE AND COMPASSIONATE CARE. OUR GOALS: * CLINICAL QUALITY * CUSTOMER SERVICE * QUALITY WORK-LIFE * FINANCIAL PERFORMANCE ORGANIZATIONAL VALUES: * SERVICE * EXCELLENCE * RESPONSIVE * VISON * INNOVATION * COMPASSION* ETHICS *ETHICS STATEMENT OF COMMUNITY COMMITMENT: TJHC IS A NONPROFIT, CHARITABLE CORPORATION OPERATED FOR THE SOLE PURPOSE OF PROMOTING AND PROVIDING FOR THE HEALTH OF THE PEOPLE IN ITS SERVICE AREA. IT DOES SO BY MAKING SURE THAT NECESSARY HOSPITAL AND HEALTH SERVICES, APPROPRIATE FOR THE SIZE OF THE COMMUNITY, ARE AVAILABLE TO ALL ON A COST-EFFECTIVE BASIS, WITHOUT REGARD TO THEIR ABILITY TO PAY. THESE INCLUDE SUCH ESSENTIAL SERVICES SUCH AS A 24-HOUR EMERGENCY ROOM, OBSTETRICS, CRITICAL CARE CAPABILITIES, AND DISASTER PREPAREDNESS.TO BE ABLE TO CONTINUE TO OFFER THESE SERVICES AT A LEVEL OF SAFETY THE COMMUNITY HAS A RIGHT TO EXPECT, THIS ORGANIZATION MUST BE ABLE TO GENERATE SUFFICIENT VOLUME AND SUFFICIENT REVENUE TO SUPPORT THOSE ESSENTIAL SERVICES WHICH, DUE TO INSUFFICIENT REIMBURSEMENT OR HIGH EXPENSES ASSOCIATED WITH THE TYPE OF SERVICE OR PATIENT INVOLVED, CANNOT SUSTAIN THEMSELVES. IT MUST ALSO RELY ON THE SUPPORT OF A HIGH QUALITY STAFF OF PHYSICIANS, NURSES AND OTHER PROFESSIONALS WHO NOT ONLY DELIVER CARE, BUT ALSO MONITOR AND WORK TO IMPROVE THE QUALITY AND EFFECTIVENESS OF THE SERVICES PROVIDED TO THE COMMUNITY. ALL POLICIES AND ACTIONS OF TJHC SHALL BE IN FURTHERANCE OF IDENTIFYING AND MEETING THE HEALTH NEEDS OF THOSE THAT WE SERVE. WITH DEDICATED STAFF POSITIONED LOCALLY, THE COMMUNITY CAN BE ASSURED ACCESS TO PRIMARY CARE. PHYSICIANS STRATEGICALLY ALIGNED WITH THE RURAL PROVIDER CAN SUCCESSFULLY MANAGE THEIR PRACTICE AND THE HEALTH OF THE LOCAL COMMUNITY. PAST STRATEGIES RECOMMENDED THAT RURAL HOSPITALS AFFILIATE WITH LARGER, URBAN HOSPITALS OR HEALTH SYSTEMS TO INCREASE THE FACILITY'S ACCESS TO CAPITAL, ADVANCED HEALTH CARE AND IMPROVED COMMUNITY HEALTH OPTIONS. TO DIRECTLY INFLUENCE ITS OWN OPERATIONS, THE DEVELOPMENT OF STRONG SPECIALTY CLINICS SHOULD INCREASE ANCILLARY UTILIZATION AND IMPROVE LOCAL CONFIDENCE IN THE HOSPITAL'S ABILITY TO MEET THE LOCAL COMMUNITY'S HEALTH DEMANDS. IN ORDER TO MEET INCREASED DEMAND FOR ANCILLARY SERVICES, RURAL HOSPITALS NEED TO EXPAND AND GROW OUTPATIENT BUSINESS. THIS IS DONE SO BY PURCHASING THE TECHNOLOGY AND LABORATORY EQUIPMENT TO KEEP TESTING IN-HOUSE. BY EXPANDING THE OUTPATIENT SERVICES OFFERED TO THE COMMUNITY AND INVESTING IN THE EQUIPMENT TO PROVIDE THOSE SERVICES, A RURAL HOSPITAL IS ABLE TO TAKE FULL ADVANTAGE OF THE BUSINESS DRIVEN BY THE SPECIALTY CLINICS. MARKETING A SITUATION WHERE YOUR CARE CAN BE MANAGED LOCALLY DRIVES FACILITY CONFIDENCE LOCALLY. THE COMMUNITY WILL BE AWARE OF THE MANY SERVICES AVAILABLE THROUGH THE HOSPITAL, ITS OUTPATIENT CENTERS AND ITS SPECIALTY CLINICS. HE AGING COMMUNITY OPENS THE DOOR TO INCREASED DEMAND FOR SUB-ACUTE HEALTHCARE. HOME HEALTH, SKILLED NURSING, AND REHABILITATION SERVICES PROVIDE AN INPATIENT HOSPITAL WITH A CONTINUUM OF CARE TO SERVE THE COMMUNITY BEYOND THE ACUTE ENVIRONMENT. EVEN IF A RESIDENT NEEDS TO SEEK SPECIALTY CARE OUT OF MARKET, EXTENSIVE SUB-ACUTE SERVICES WILL RETURN THE PATIENT TO THEIR COMMUNITY WHERE THEY ARE COMFORTABLE AND FAMILIAR TO THE SURROUNDINGS. TJHC IS VERY INVOLVED IN THE COMMUNITY. * AMERICAN CANCER SOCIETY-RELAY FOR LIFE * AMERICAN HEART ASSOCIATION-HEART WALK AND WEAR RED DAY * HEALTH EDUCATION THEATRE * MARCH OF DIMES WALK AMERICA * SUSAN G. KOMEN * UNITED WAY * LINDSEY WILSON COLLEGE PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: TJ REGIONAL HEALTH INC. : AS OF DECEMBER 2015, TJHC BECAME A SUBSIDIARY OF T. J. REGIONAL HEALTH, INC. THIS ORGANIZATION SERVES AS THE PARENT ORGANIZATION AND WAS FORMED TO HELP FACILITATE THE ORGANIZATIONS PLANS TO BECOME MORE REGIONALLY FOCUSED. TJHC ALONG WITH T.J. SAMSON COMMUNITY HOSPITAL AND T. J. HEALTH PARTNERS, LLC ARE ALL SUBSIDIARIES OF T. J. REGIONAL HEALTH, INC. T. J. HEALTH PARTNERS, LLC. OPERATES PHYSICIAN CLINICS THAT INCLUDE FAMILY MEDICINE, INTERNAL MEDICINE, CARDIOLOGY, UROLOGY, NEUROLOGY, GYNECOLOGY AND PAIN MANAGEMENT. T. J. HEALTH PARTNERS, LLC IS A PHYSICIAN MULTI-SPECIALTY CLINIC THAT OFFERS PATIENTS EASY ACCESS TO CARE. THE COMPREHENSIVE SERVICES ALLOW PATIENTS TO REMAIN IN THE COMMUNITY FOR THEIR HEALTHCARE NEEDS. T.J. SAMSON COMMUNITY HOSPITAL IS A 196-BED, ACUTE-CARE FACILITY PROVIDING HEALTHCARE SERVICES TO BARREN AND SURROUNDING COUNTIES. AS COMMUNITY NEEDS ARE IDENTIFIED, ONGOING EFFORTS WILL BE MADE TO EXPAND THE OFFERINGS. SPECIALTIES RANGE FROM PRIMARY CARE TO INVASIVE/INTERVENTIONAL CARDIOLOGY, UROLOGY, PULMONARY, ONCOLOGY, AND NEUROLOGY. EACH OFFICE IS DESIGNED TO MEET AS MANY OF THE PATIENT'S NEEDS IN THE OFFICE SETTING AS POSSIBLE. T.J. HEALTH PAVILION IS AN OUTPATIENT SERVICE FACILITY OWNED AND OPERATED BY T.J. SAMSON COMMUNITY HOSPITAL AND IS DESIGNED TO MEET THE DEMAND OF RISING OUTPATIENT VOLUMES. THE T.J. HEALTH PAVILION HOUSES THE PHYSICIAN GROUP OF T.J. HEALTH PARTNERS AND THE OUTPATIENT SERVICES OF T.J. SAMSON COMMUNITY HOSPITAL. THE FACILITY ALLOWS THE COMMUNITY ACCESS TO A WIDE ARRAY OF SERVICES AND TECHNOLOGY ALL LOCATED IN ONE CONVENIENT LOCATION. SERVICES AND SPECIALTIES INCLUDE; REHABILITATION, DIALYSIS, URGENT CARE SERVICES, LABORATORY, RADIOLOGY, PRIMARY CARE, ONCOLOGY, UROLOGY, PAIN MANAGEMENT, SURGERY PHYSICIANS, OBSTETRICS AND GYNECOLOGY, CARDIOLOGY, AND NEPHROLOGY. T.J. HEALTH COLUMBIA IS A 74-BED, (25 FOR BHU AND 49 FOR ACUTE-CARE) FACILITY PROVIDING HEALTHCARE SERVICES TO ADAIR AND SURROUNDING COUNTIES. THE BHU UNIT WAS CLOSED IN JULY OF 2018. 0 0 0 0 0 0 0 1 0 JOHN CRADDOCK FORMER VICE CHIEF OF STAFF 0 502078 0 105568 0 5000 0 13200 0 25487 0 651333 0 0 NEIL THORNBURY CEO 0 505570 0 79103 0 0 0 35420 0 25487 0 645580 0 0 MICHAEL SARIDAKIS MD DIRECTOR/CHIEF OF STAFF (END 12/23) 0 416895 0 62444 0 10000 0 13200 0 25487 0 528026 0 0 MEI DENG CFO 0 330262 0 37500 0 0 0 12656 0 18184 0 398602 0 0 ERIC FISHER FORMER CHIEF OF STAFF 0 359113 0 0 0 0 0 11453 0 25487 0 396053 0 0 ASHLEY MATNEY NURSE PRACTITIONER 269733 0 51407 0 10769 0 10243 0 15253 0 357405 0 0 0 CLINTON KITECK PHYSICIAN 265513 0 42199 0 5000 0 10800 0 25487 0 348999 0 0 0 PATRICIA DOOLIN NURSE PRACTITIONER 115140 0 88424 0 2000 0 4680 0 9376 0 219620 0 0 0 EMILY JESSIE NURSE PRACTITIONER 118296 0 64243 0 2000 0 4229 0 14997 0 203765 0 0 0 TERESA SHEFFIELD NURSE PRACTITIONER 110191 0 71627 0 2024 0 4480 0 734 0 189056 0 0 0 PART I, LINE 3 TJ REGIONAL HEALTH, INC., A RELATED ORGANIZATION OF TJ HEALTH COLUMBIA, INC., USES COMPENSATION SURVEYS/STUDIES AND 990S OF OTHER HOSPITALS SIMILAR IN SIZE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO. THIS PROCESS IS REVIEWED AND APPROVED ANNUALLY BY THE EXECUTIVE BOARD. PART I, LINE 7 PHYSICIANS ARE ELGIBLE FOR INCENTIVE COMPENSATION. PHYSICIANS MAY EARN ADDITONAL COMPENSATION THROUGH QUARTERLY PRODUCTIVITY BONUSES THAT ARE BASED ON THE CALCULATED DIFFERENCE OF ACTUAL WRVUS FOR THE QUARTER LESS A WRVU QUARTERLY TARGET. THE OFFICER'S BONUSES ARE CALCULATED BASED ON STANDARD PERFORMANCE METRICS AS MEASURED BY ANNUAL CMS PATIENT SATISFACTION SURVEY RESULTS, ANNUAL EMPLOYEE SATISFACTION AND TURNOVER RESULTS, ANNUAL CMS HOSPITAL QUALITY SCORES IMPROVEMENT, FINANCIAL PERFORMANCE TO GOALS, SERVICE LINE GROWTH AND MARKET SHARE EXPANSION, AND COMMUNITY DEVELOPMENT SUPPORT AND PROGRESS. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S CEO, CFO, AND OFFICERS OF THE BOARD (CHAIRMAN, VICE CHAIRMAN, FINANCE COMMITTEE). FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REVIEWS THE POLICY AND ENSURES COMPLIANCE BY ALL MEMBERS ANNUALLY. EACH MEMBER MUST ANNUALLY DISCLOSE COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A AND 15B: RELATED ORG, TJ REGIONAL HEALTH, INC., COMPENSATES ALL OFFICERS. TJ REGIONAL USES AN INDEPENDENT THIRD PARTY TO HELP ESTABLISH WAGES FOR THE CEO. COMPARABILITY DATA USED INCLUDED IHA COMPENSATION SURVEYS, AND 990S OF OTHER HOSPITALS SIMILAR IN SIZE. THIS PROCESS IS REVIEWED AND APPROVED BY THE EXECUTIVE BOARD ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FROM THE ORGANIZATION. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 65,295. MANAGEMENT AND GENERAL EXPENSES 7,255. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,550. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 644,470. MANAGEMENT AND GENERAL EXPENSES 71,608. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 716,078. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,771,046. MANAGEMENT AND GENERAL EXPENSES 362,744. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,133,790. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. TJ REGIONAL HEALTH INC 1301 NORTH RACE STREET GLASGOW KY 42141 273988336 PARENT ORGANIZATION OF HEALTHCARE FACILITY KY 501(C)(3) LINE 12B, II N/A 0 TJ SAMSON COMMUNITY HOSPITAL 1301 NORTH RACE STREET GLASGOW KY 42141 610461767 HOSPITAL KY 501(C)(3) LINE 3 TJ REGIONAL HEALTH INC 0 TJ COMMUNITY MISSION FOUNDATION 1301 NORTH RACE STREET GLASGOW KY 42141 472208322 FOUNDATION KY 501(C)(3) LINE 10 TJ REGIONAL HEALTH INC 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0