2021-11-15T14:31:55-08:00 2020-12-31 Strickland & Barksdale CPA's PO Box 506 Russellville AL 35653 990 2020-01-01 472378825 Russellville Hospital Inc RUSS 2563321611 PO Box 1089 Russellville AL 35653 Ashoke A Mukherji President 2563321611 2021-10-29 true Ashoke Mukherji XXX-XX-XXXX Donna S Barksdale CPA P00047643 2563322275 2021-11-15 X 3 AAL1 IAL1 FAL1 2020 2022-09-23 18:48:47Z Ashoke A Mukherji PO Box 1089 Russellville AL 35653 26432970 false X RussellvilleHospital.com X 2014 AL Our mission is making communities healthier. Russellville Hospital is a rural acute care hospital. 8 6 307 0 0 0 15835 4355232 22391480 21877505 0 317894 200233 22725209 26432970 0 0 11623101 12845943 0 0 11854399 13694971 23477500 26540914 -752291 -107944 6332870 10029714 9479204 13283992 -3146334 -3254278 Our mission is making communities healthier. Russellville Hospital is a rural acute care hospital. false false 21737271 0 21877505 Seeks to improve the delivery of healthcare services in rural America by giving local healthcare organizations an alternative to for-profit hospital companies or health systems. Seeks to make the community healthier. 21737271 true false false false false false false false false false true false false true true false false false false false false false false false false false true true false false true false false false true false false false false false false false false true true true false false false true 65 0 true 307 true false false false false false false false false false false X 8 6 false true false false false false false true true false false true true true true true true true true false X Shannon Hughes 2563328625 15155 Highway 43 Russellville AL 35653 Bill Foster Board Moderator 0.00 X 0 0 0 Keith Morrow DO Chief of Staff 0.00 X 0 0 0 Lloyd Dyas MD Board Member 0.00 X 0 0 0 Jeffrey Manord Board Member 0.00 X 0 0 0 Jerry Groce Board Member 0.00 X 0 0 0 Miranda Decker MD Board Member 0.00 X 0 0 0 Roger Bedford Board Member 0.00 X 0 0 0 Marilyn Mayfield Board Member 0.00 X 0 0 0 Christine Stewart CEO/Board Secretary 40.00 X X 96767 0 3845 Stephen Proctor CEO/Board Secretary 40.00 X X 152759 0 14459 John Almirol Physician 40.00 X 396548 0 51489 Jeffrey Chenyi Physician 40.00 X 326455 0 58736 Tracy Martin CFO 40.00 X 39548 0 1664 Shannon Hughes CFO 40.00 X 78574 0 4937 Tracy Vinson Pharmacy Director 40.00 X 129453 0 500 Russell Burks Physical Therapy Director 40.00 X 121369 0 5181 Karen Waddell Med Surg/ICU/Nursing Director 40.00 X 118062 0 7463 1459535 0 148274 7 false true false Correct Care Inc 229 Saint John Lane Covington LA 70433 Physician services 802008 Integrated Behavioral Health 600 Sun Temple Drive Madison AL 35758 Billing services 273020 Java Medical Group 6 Castlewood Ct Nashville TN 37215 Management services 360000 JMJ Anesthesia PC PO Box 757 Suite F Florence AL 356310757 Anesthesiologist services 415329 Community Health Care Trust Services PO Box 305172 Dept 123 Nashville TN 372305172 Rent 140175 7 4338828 16404 4355232 Patient service fees 622110 21877505 0 0 21877505 139673 139673 139673 139673 Cafeteria revenue 900099 42933 42933 0 0 Other revenue 900099 17627 17627 0 0 60560 26432970 22077738 0 0 1553761 1413295 140466 0 9109918 8595941 513977 0 2182264 2142864 39400 0 360000 0 360000 0 4210360 3907378 302982 0 303128 275453 27675 0 244395 0 244395 0 583686 0 583686 0 315736 0 315736 0 7677666 5402340 2275326 0 26540914 21737271 4803643 0 14860 1394605 1812494 2132400 2500000 27238 827524 772368 248916 160139 7628198 4636975 3412080 2991223 16996 51741 6332870 10029714 2502699 1906948 5410170 5191796 1761873 1566335 4423375 9479204 13283992 X -3146334 -3254278 -3146334 -3254278 6332870 10029714 -107944 X false false false X 0 0 0 0 0 0 810000 810000 2296794 569864 1726930 175471 66195 109276 4319553 4000916 318637 26380 0 26380 2991223 Current portion LTD 245 Deposits 51496 51741 Accrued salaries/benefits 924332 Other current liabilities 3392455 Bank overdrafts 0 A/P Lakeland Community Hospital 0 Accounts receivable - other 106588 4423375 true true true X true X true false false 1420372 1420372 0.05350 4597285 1152899 3444386 0.12980 0 0.00000 6017657 1152899 4864758 0.18330 684 684 0.00000 2299 2299 0.00010 0 0.00000 0 0 0.00000 2983 2983 0.00010 6020640 1152899 4867741 0.18340 true 11569611 7470262 5783742 1686520 true true 1 1 Russellville Hospital Inc 15155 Highway 43 Russellville AL 35653 Russellville Hospital.com H3001 X X X Russellville Hospital Inc 1 false false true X X X X X X X X X 19 true false false true X RussellvilleHospital.com X true 19 true RussellvilleHospital.com false false true X 200.000000000000 300.000000000000 true true X X X X true X RussellvilleHospital.com X RussellvilleHospital.com X RussellvilleHospital.com X X X true X false X true X false false Russellville Hospital, Inc. Pt V Line 5 The goal of establishing the community health committee was to solicit input from residents of the community and to promote the broad interest of those served by the hospital. Community members of the committee are as follows: Bill Foster, Leah Youm, Maria Macias, Thomas Uptain, and Dr. Wayne Ray. The committee met to ultimately identify the top health issues facing the community and the development of the hospital's implementation strategy to address the findings of the CHNA. An online survey was the primary means to determine public perception about the needs of the community. Input was requested regarding demographics and health status. In order to receive input from the medically underserved, chronically ill and low-income individuals, and to ensure data from the overall population, the survey was advertised by various community partners. These partners also helped distribute through their email list services. The survey was available to the public through RussellvilleHospital.com for a five-week period. Russellville Hospital, Inc. Pt V Line 20e Responsible parties are provided a written notice about extraordinary collection action and a plain language summary of the FAP at least 30 days before action is taken. A reasonable effort is made to orally notify responsible parties about the FAP and the FAP application process. 1 Russellville Physicians LLC 15155 Highway 43 Russellville AL 35653 Family medicine physician facility Russellville Physicians LLC 15155 Highway 43 Russellville AL 35653 Family medicine physician facility Pt III Line 2 Accounts are evaluated for collectability on a monthly basis using aged payor account classifications and historical collection experience. Pt III Line 3 Accounts are evaluated for collectability on a monthly basis using aged payor account classifications and historical collection experience. Pt III Line 8 As a non-profit organization, the hospital accepts all patients without regard to insurance or ability to pay. Amounts are based on the Medicare Cost Report. Pt III Line 9b Russellville Hospital offers financial assistance to patients and guarantors through a charity policy based on the current federal poverty guidelines (FPG). Those approved for financial assistance are eligible for discounts applied to balances owed after insurance. Self-pay balances remaining after the uninsured discount are also eligible for financial assistance.If the family income of the patient is between 0% and 200% of the FPG, a 100% discount may be applied (charity care). If the family income of the patient is between 201% and 250% of the FPG, a 60% discount may be applied (financial assistance). If the family income of the patient is between 251% and 300% of the FPG, a 40% discount may be applied (financial assistance). This policy is publicized in patient registration areas, included in billing statements, and is available on the hospital's web site. Patients with a balance remaining after application of discounts are sent statements and/or collection letters every 30 days until the balance is paid or payment arrangements are made. Accounts that do not have sufficient payment arrangements established are eligible to be referred to outside collections. All patients are notified of possible collection assignment at least 30 days before an assignment is made. If a request for financial assistance is made after statements are sent, the account is placed on hold until a determination of eligibility is made. Pt VI Line 2 The hospital performs outreach services and health education opportunities for the community. Feedback from these services as well as evaluation of the patients served are used to assess the community's health care needs. Pt VI Line 3 Both inpatient and outpatient services are eligible for financial assistance or charity upon application by the patient or guarantor. There is signage in registration areas, information included in monthly statments,and information on the hospital website with the phone number to call for financial assistance. Pt III Line 4 Russellville Hospital primarily serves residents of Russellville, Alabama and Franklin County, Alabama. Russellville is a rural community with population of just below 10,000 and approximately 22% of the population is below poverty level. The most recent census indicates the population is 73% caucasian. Pt VI Line 5 The hospital has a volunteer Board of Directors and is served by an open medical staff. The hospital actively recruits primary care physicians and specialists to meet medical needs in the community. The hospital also performs outreach services and provides health education opportunities for the community. X X X X false false false false false false false true false Stephen Proctor 152759 0 1500 0 0 0 12959 0 0 0 167218 0 0 0 John Almirol 396548 0 46808 0 0 0 4681 0 0 0 448037 0 0 0 Jeffrey Chenyi 326455 0 43918 0 0 0 14818 0 0 0 385191 0 0 0 Shannon Hughes 78574 0 500 0 0 0 4437 0 0 0 83511 0 0 0 Tracy Vinson 129453 0 500 0 0 0 0 0 0 0 129953 0 0 0 Russell Burks 121369 0 500 0 0 0 4681 0 0 0 126550 0 0 0 Karen Waddell 118062 0 500 0 0 0 6963 0 0 0 125525 0 0 0 Pt I Line 7 Physicians were eligible for productivity bonuses. Java Medical Group Management Services Business X 2500000 2500000 false false false 2500000 Pt VI, Line 3 Management services were performed by Java Medical Group. Pt VI, Line 11b A copy of Form 990 was provided to each Board Member for review prior to the filing of the form. Pt VI, Line 12c The conflict of interest policy is reviewed annually with governing Board Members and a Conflict of Interest statement is completed annually. Pt VI, Line 15a The Board approves the operating budget which includes CEO and top management compensation. Pt VI, Line 15b The Board approves the operating budget which includes officer and key employee compensation. Pt VI, Line 19 Governing documents, conflict of interest policy and financial statements are made available to the public upon request. Other Part IV, Line 20b An audit has not been completed for the year ending December 31, 2020. Form 990, Part IX, Line 11g Professional fees 955836. 955836. 0. 0. Form 990, Part IX, Line 11g Purchased Services 3254524. 2951542. 302982. 0. Form 990, Part IX, Line 24e Taxes and assessments 1611953. 0. 1611953. 0. Form 990, Part IX, Line 24e Supplies and other 3953270. 3911260. 42010. 0. Form 990, Part IX, Line 24e Repairs and maintenance 898374. 689846. 208528. 0. Form 990, Part IX, Line 24e Utilities 679127. 571279. 107848. 0. Form 990, Part IX, Line 24e Other expense 534942. 229955. 304987. 0. Russellville Physicians LLC 15155 Highway 43 Russellville AL 35653 472497573 Provide health care services TN 769962 619021 Russellville Hospital Inc Russellville Medical II Condominum Assoc PO Box 1089 Russellville AL 35653 630944658 Condo maint AL C 0.50000 false false false false false false false false false false false false false false false false false false false false