2021-08-09T10:22:02-05:00 2020-09-30 621046406 JOHNSON HICKEY & MURCHISON PC 2215 OLAN MILLS DRIVE CHATTANOOGA TN 37421 990 2019-10-01 311131099 OHIO COUNTY HOSPITAL CORPORATION OHIO 2705044050 1211 OLD MAIN STREET HARTFORD KY 42347 SHELLIE SHOUSE CFO 2705044050 2021-08-09 1 BARRY R HUGGINS P00627334 4237560052 2019 2022-09-23 18:48:47Z OHIO COUNTY HEALTHCARE SHELLIE SHOUSE 1211 OLD MAIN STREET HARTFORD KY 42347 50263078 0 X HTTPS://OCHCARES.COM/ X 1984 KY OHIO COUNTY HEALTHCARE EXISTS TO HELP MAKE A DIFFERENCE BY CARING,SERVING AND EDUCATING INDIVIDUALS RELATIVE TO THEIR SPECIFIC HEALTH NEEDS. THROUGH THESE ACTIONS,THE GENERAL HEALTH OF OHIO COUNTY AND SURROUNDING AREAS WILL IMPROVE. 9 8 647 10 0 0 30554 3190193 40295632 42768954 128158 112610 4445433 4191321 44899777 50263078 0 0 0 0 23257860 26285399 0 0 0 21207407 22059529 44465267 48344928 434510 1918150 19116076 31158222 8973262 19097258 10142814 12060964 X OHIO COUNTY HEALTHCARE EXISTS TO HELP MAKE A DIFFERENCE BY CARING,SERVING AND EDUCATING INDIVIDUALS RELATIVE TO THEIR SPECIFIC HEALTH NEEDS. THROUGH THESE ACTIONS,THE GENERAL HEALTH OF OHIO COUNTY AND SURROUNDING AREAS WILL IMPROVE. 0 0 42521525 46960275 THE MISSION OF OHIO COUNTY IS TO MAKE A DIFFERENCE IN THE LIVES OF OTHERS BY CARING, SERVING, AND EDUCATING INDIVIDUALS RELATIVE TO THEIR SPECIFIC HEALTH NEEDS. WE BELIEVE THAT THROUGH THESE ACTIONS, THE GENERAL HEALTH OF OHIO COUNTY HOSPITAL IS THE FRONTLINE OF COMMUNITY HEALTHCARE, PROVIDING A SAFETY NET 24 HOURS A DAY THROUGH OUR INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. IN ORDER TO MEET THE CHANGING NEEDS OF THE COMMUNITY AND IMPROVE THE ACCESS TO HEALTH CARE, WE HAVE EXPANDED OUR SERVICES TO INCLUDE PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. AND WHILE PATIENTS BENEFIT FROM OUR BEING CLOSE BY, ULTIMATELY IT IS THE WHOLE COMMUNITY THAT PROSPERS FROM OUR PRESENCE. THE HOSPITAL'S POSITIVE IMPACT ON THE COMMUNITY EXTENDS WELL BEYOND THE FOUR WALLS OF THE FACILITY. OUR COMMUNITY BENEFIT INCLUDES NOT ONLY THE COST OF PROVIDING CARE TO THE UNINSURED AND INDIGENT BUT ALSO BY IDENTIFYING UNMET COMMUNITY OR PUBLIC HEALTH NEEDS AND SEEKING TO ADDRESS THEM. EXAMPLES OF SUCH EFFORTS INCLUDING SUPPLYING CHILDHOOD IMMUNIZATION VACCINES TO OUR LOCAL HEALTH DEPARTMENT AT NO CHARGE. BECOMING A SMOKE-FREE FACILITY, AND OFFERING FREE SMOKING CESSATION COURSES SEVERAL TIMES A YEAR TO ALL COMMUNITY MEMBERS. OHIO COUNTY HOSPITAL WAS THE FOUNDING MEMBER OF A LOCAL HEALTH COALITION WHOSE FOCUS IS TO IMPLEMENT PREVENTATIVE HEALTH ACTIVITIES TO COMBAT THE LACK OF PHYSICAL ACTIVITY AND THE PREVELENCE OF OBESITY IN OUR AREA. WHETHER IT'S THROUGH THE PEOPLE WE EMPLOY, THE LOCAL BUSINESSES WE USE, OR THE CHARITIES AND COMMUNITY ACTIVITIES WE SUPPORT, WE ARE COMMITTED TO MAKING THE OHIO COUNTY AREA A HEALTHIER PLACE TO LIVE AND WORK. DURING THE FISCAL YEAR 2020, THE HOSPITAL PROVIDED HEALTH CARE SERVICES TO OHIO COUNTY KENTUCKY AND SURROUNDING AREAS, INCLUDING INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. OHIO COUNTY HOSPITAL PROVIDED $399,544 OF CHARITY CARE THROUGH ITS CHARITY CARE PROGRAM. 42521525 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 47 0 647 1 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X SHELLIE SHOUSE 2705044050 1211 OLD MAIN STREET HARTFORD KY 42347 JONATHAN SHREWSBURY OD DIRECTOR 2.00 X 0 0 0 JIM DUKE VICE PRESIDENT 2.00 X X 0 0 0 KELLY ROE DIRECTOR 2.00 X 0 0 0 CARLA WALLACE SECRETARY/TREASURER 2.00 X X 0 0 0 EDDIE EMBRY DIRECTOR 2.00 X 0 0 0 LLOYD SPIVEY PRESIDENT 2.00 X X 0 0 0 MUKESH DESAI MEDICAL STAFF REPRESENTATI 40.00 X 600000 0 59268 PAT GIBSON DIRECTOR 2.00 X 0 0 0 BETH LUNSFORD DIRECTOR 2.00 X 0 0 0 JOSHUA SKIBBA CARDIOLOGIST/CMO 40.00 X 383342 0 39832 ATHENA MINOR CHIEF CLINICAL OFFICER 40.00 X 81638 0 4960 CHARLES RICCIO GASTROENTEROLOGIST 40.00 X 533037 0 53036 STEVEN MILLS PHYSICIAN 40.00 X 511721 0 20173 ALEX ARGOTTE PHYSICIAN ER 40.00 X 717301 0 23859 BRUCE DURHAM PHYSICIAN 40.00 X 268745 0 24052 BAILEY PHELPS MD PHYSICIAN 40.00 X 320749 0 20813 3416533 0 245993 7 0 1 0 ORTHAPAEDICS AND SPORTS MEDICINE 2831 NEW HARTFORD RD OWENSBORO KY 42303 ORTHOPEDIC SURGERIES 837210 QUOROM HEALTH RESOURCES 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT FEES 293828 GEORGE GILLIAM MD 2100 SOUTH STRATFORD DRIVE OWENSBORO KY 42301 PHYSICIAN SURGICAL 275760 EMCARE PHYSICIAN SERVICES 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ER PHYSICIANS 194016 KRISTA SMITH 2162 N STAPLEY DRIVE MESA AZ 85203 CLEANING SERVICES 177386 8 3143000 47193 3190193 NET PATIENT SERVICES 621300 42768954 42768954 42768954 106810 106810 5800 0 5800 5800 5800 MISCELLANEOUS REVENUE 611430 3637078 3637078 CLINIC REVENUE 621400 250204 250204 PAIN MANAGEMENT CENTER 621400 192157 192157 111882 111882 4191321 50263078 46960275 0 112610 X 509772 509772 22110535 19522487 2588048 187344 161269 26075 1926923 1705104 221819 1550825 1368790 182035 293828 293828 80458 80458 106637 15999 90638 5254914 4154188 1100726 72424 72424 179487 120680 58807 1953674 1376644 577030 54883 40308 14575 23857 21227 2630 193554 171331 22223 929629 822893 106736 583445 536711 46734 MEDICAL SUPPLIES AND DR 8112213 8112213 BAD DEBT 3085520 3085520 TAXES AND LICENSES 468735 414917 53818 DUES AND SUBSCRIPTIONS 286524 162105 124419 379747 219367 160380 48344928 42521525 5823403 0 5789216 15571104 381800 385250 4012334 4708474 93271 33489 497901 430258 934184 988230 248115 260083 27868166 19914588 6424849 7953578 734406 827756 19116076 31158222 3499198 4094581 2340381 2168528 1515221 1835523 4559710 1618462 6438916 8973262 19097258 X 10142814 12060964 10142814 12060964 19116076 31158222 1918150 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4000 4000 0 PART II-B, LINE 1: THE HOSPITAL PAYS DUES TO THE KENTUCKY HOSPITAL ASSSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED FOR LOBBYING. 765929 765929 8987137 5312533 3674604 17440650 14151855 3288795 674450 450200 224250 7953578 THIRD PARTY SETTLEMENTS 141888 RETIREMENT BENEFITS 655372 MEDICARE ADVANCE PAYMENTS 3949529 REFUNDABLE ADVANCE 1692127 6438916 X 50263078 0 50263078 0 50263078 48344928 0 48344928 0 48344928 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740-10 "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES" WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS WITHIN THE FINANCIAL STATEMENTS. THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2020 AND 2019. AS OF SEPTEMBER 30, 2020 AND 2019, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTIONS. WITH A FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2017. 1 1 1 X 1 X 1 1 0 0 640039 640039 0.01410 8928662 6241711 2686951 0.05940 9568701 6241711 3326990 0.07350 7538 7538 0.00020 7538 7538 0.00020 9576239 6241711 3334528 0.07370 1 1437891 186193 10549318 10523505 25813 X 1 1 1 1 OHIO COUNTY HOSPITAL CORPORATION 1211 OLD MAIN STREET HARTFORD KY 42347 1629007430 X X X OHIO COUNTY HOSPITAL CORPORATION 1 0 0 1 X X X X X X X X 19 1 0 1 1 X HTTPS://OCHCARES.COM/ X 1 19 1 HTTPS://OCHCARES.COM/ 0 1 X 100.000000000000 100.000000000000 X 1 1 X X X X 1 X HTTPS://OCHCARES.COM/ X HTTPS://OCHCARES.COM/ X HTTPS://OCHCARES.COM/ X X X X X X 1 X 0 X X X X 1 X 0 0 OHIO COUNTY HOSPITAL CORPORATION PART V, SECTION B, LINE 5: THE HOSPITAL CONDUCTED THE NEEDS ASSESSMENT WITH THE GREEN RIVER COMMUNITY DISTRICT HEALTH DEPARTMENT. LOCAL COMMUNITIES UTILIZED THE RESULTS OF THE COMMUNITY HEALTH ASSESSMENT AS A GUIDE TO ESTABLISH PRIORITIES AND DEVELOP STRATEGIC PLANNING EFFORTS TO EFFECTIVELY IMPROVE THE HEALTH OF THE COMMUNITIES. COUNTY PARTNERS CREATED WORK GROUPS TO FOCUS ON SPECIFIC STRATEGIC INITIATIVES AND IDENTIFIED AGENCIES OR INDIVIDUALS TO LEAD EACH WORK GROUP. OHIO COUNTY HOSPITAL CORPORATION PART V, SECTION B, LINE 6B: GREEN RIVER COMMUNITY DISTRICT HEALTH DEPARTMENT (DAVIESS, HANCOCK, HENDERSON, MCLEAN, OHIO, UNION,AND WEBSTER COUNTIES) OHIO COUNTY HOSPITAL CORPORATION PART V, SECTION B, LINE 13H: PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% BUT NOT MORE THAN 400% 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 OHIO COUNTY HOSPITAL; HOWEVER THE DISCOUNTED RATES SHALL NOT BE GREATER THE THE AMOUNTS GENERALLY BILLED TO (RECEIVED BY THE HOSPITAL FOR)COMMERCIALLY INSURED [OR MEDICARE]PATIENTS. OHIO COUNTY HOSPITAL CORPORATION PART V, SECTION B, LINE 18E: THE HOSPITAL USES AN OUTSIDE COMPANY-DMC WHO DETERMINES IF ALL OF THE PRIVATE PAY PATIENTS FIRST ARE ELIGIBLE FOR MEDICAID AND IF THEY ARE NOT THEY DETERMINE IF THEY ARE ELIGIBLE FOR THE STATE INDIGENT PROGRAM. IF THEY ARE ELIGIBLE FOR THE STATE PROGRAM THE ENTIRE BALANCE IS WRITTEN OFF. IF THE PRIVATE PAY PATIENTS ARE ELIGIBLE FOR EITHER OF THE TWO PROGRAMS, THE HOSPITAL HAVE BEGAN OFFERING (OCTOBER 2011), A PRIVATE PAY DISCOUNT WHICH INITIALLY DISCOUNTS 50% OFF THE PATIENT'S ACCOUNT BALANCE. ALL OF THE PRIVATE PAY PATIENTS RECEIVE 3 STATEMENTS, 2 LETTERS AND SOMETIMES ANOTHER LETTER BEFORE BEING SENT TO THE COLLECTIONS AGENCY. THE COLLECTION AGENCY THEN DETERMINES THE ABILITY TO PAY, AND THEY TAKE ACTIONS BASED ON THE RESULTS OF THEIR FINDINGS. OHIO COUNTY HOSPITAL CORPORATION PART V, SECTION B, LINE 20E: ADMITTING CLERKS PROVIDE EACH UNINSURED PATIENT A CHARITY CARE APPLICATION AND ENCOURAGE HER TO COMPLETE THE FORM. IT MUST BE DOCUMENTED THAT THE PATIENT HAS NO CURRENT VALID INSURANCE COVERAGE AND IS NOT ELIGIBLE TO APPLY FOR PUBLIC ASSISTANCE OR OTHER INSURANCE. THE PATIENT MUST MEET THE CRITERIA ESTABLISHED BY THE STATE TO QUALIFY FOR THE CHARITY CARE PROGRAM.THE ECA IS ON OUR LETTERS THAT GOES OUT TO THE PATIENT.THE DMC CHECKS ALL PRIVATE PAY FOR ANY MEDICAID THAT THEY MAY BE ELGIBLE FOR.IF WE HAD ANY OPEN APPLICATIONS THEY MAY BE CONSIDERED BEFORE ECA. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,085,520. PART III, LINE 4: EXPLANATION FOR HOW BAD DEBT IS CALCULATED IS PROVIDED IN THE FOOTNOTE OF THE FINANICIALS.ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT THE HOSPITAL EXPECTS TO COLLECT. THE HOSPITAL MAINTAINS ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE INABILITY OF ITS PATIENTS TO MAKE REQUIRED PAYMENTS. MANAGEMENT CONSIDERS THE FOLLOWING FACTORS WHEN DETERMINING THE COLLECTABILITY OF PATIENT ACCOUNTS: PAYOR CREDIT-WORTHINESS, PAST TRANSACTION HISTORY WITH THE PAYOR, CURRENT ECONOMIC INDUSTRY TRENDS, AND CHANGES IN PAYOR PAYMENT TERMS. IF THE FINANCIAL CONDITION OF THE HOSPITAL'S PAYORS OR PATIENTS WERE TO DETERIORATE, ADVERSELY AFFECTING THEIR ABILITY TO MAKE PAYMENTS, ADDITIONAL ALLOWANCES WOULD BE REQUIRED. BASED ON MANAGEMENT'S ASSESSMENT, THE HOSPITAL PROVIDES FOR ESTIMATED UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO EARNINGS AND A CREDIT TO ALLOWANCE. BALANCES THAT REMAIN OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE AMOUNT IN LINE 7 WAS THE COST TO CHARGE RATIO. PART III, LINE 9B: ALL ACCOUNTS MOVE THROUGH THE REGISTRATION, MEDICAL CODING AND INSURANCE BILLING PROCESS. IF THE PATIENT HAS AN INSURANCE OR GOVERNMENT PLAN THAT PAYER WILL BE BILLED. ONCE THEY PAY, THE ACCOUNT IS REVIEWED FOR CORRECT BALANCE. THEN CPSI ASSIGNS A CYCLE CODE TO EACH ACCOUNT WHICH DRIVES WHEN A STATEMENT WILL BE ISSUED. THE STATEMENTS THEN FOLLOW IN 28 DAY CYCLES. EACH PATIENT SHOULD RECEIVE AT LEAST 3 STATEMENTS AND 2 LETTERS. WITH THIS CYCLE EVERY PATIENT WILL RECEIVE STATEMENTS FOR GREATER THAN 120 DAY PERIOD. IN THE EVENT THE PATIENT MAKES A PAYMENT SATISFYING PAYMENT TERMS ON THE ACCOUNT, THE STATEMENT CYCLE IS SET BACK TO THE BEGINNING. A PATIENT WITH NO INSURANCE GOES THROUGH REGISTRATION, A REVIEW FOR ANY POSSIBLE PAYER AND KENTUCKY DSH PROGRAM. ONCE IT HAS BEEN DETERMINED THAT THERE IS NO OTHER PAYER SOURCE, THE DSH APPLICATIONS ARE SENT TO DMS CONSULTANTS FOR REVIEW OF POTENTIAL MEDICAID OR DSH APPROVAL. DMC NOTIFIES OHIO COUNTY HOSPITAL IF THE PATIENT HAS EITHER INSURANCE, MEDICAID OR HAS BEEN APPROVED FOR THE DSH PROGRAM. ADJUSTMENTS ARE MADE ACCORDINGLY FROM THESE FINDINGS. IF NO INSURANCE AND NOT QUALIFIED FOR ANY PROGRAMS A DENIAL IS SENT TO THE PATIENT.THE PRIVATE PAY PATIENTS ARE ALSO RECEIVING THE SAME BILLING CYCLE AS ALL OTHER PAYERS. DURING THIS CYCLE WE ALSO RECEIVE INCOMING CALLS AND PATIENT WALK IN'S, AS WELL AS MAKING PHONE CALLS AS TIME PERMITS FOR ADDITIONAL ATTEMPTS TO COLLECT. ALL ACCOUNTS ARE DOCUMENTS AS STATEMENTS, LETTERS AND PHONE CALL ATTEMPTS ARE MADE AT THE ATTEMPT TO COLLECT THE BALANCE OF THE ACCOUNT. IN THE EVENT THAT OHIO COUNTY HOSPITAL STAFF HAS BEEN UNABLE TO COLLECT THE OUTSTANDING DEBT, ACCOUNTS ARE TURNED OVER TO AN OUTSIDE COLLECTION AGENCY. THE AGENCY THEN FOLLOWS AS DIRECTED BY OCH TO ATTEMPT FOR AN ADDITIONAL 120 DAYS OR NO PAYMENT WITHIN THE LAST 12 MONTHS. THEIR ATTEMPTS ALSO INCLUDES LETTERS, PHONE CALLS AND PLACED ON CREDIT REPORTING SYSTEMS. IN THE EVENT THAT THE COLLECTION AGENCY HAS BEEN UNSUCCESSFUL AT THE COLLECTION, THE ACCOUNTS WILL BE DEEMED UNCOLLECTIBLE, CLOSED AND RETURNED FROM CREDIT REPORTING AND THEN CANCELED BACK TO HOSPITAL. HOSPITAL STAFF THEN PLACES A NOTE ON THAT ACCOUNT THAT IT HAS BEEN DEEMED UNCOLLECTIBLE. HOSPITAL OR COLLECTION AGENCY MAKES NO FURTHER ATTEMPTS AT COLLECTION AT THIS POINT. HOSPITAL COMPILES A REPORT FOR THE UNCOLLECTIBLE DEDUCTIBLE AND CO INSURANCE THAT HAVE BEEN DEEMED IN THE SAME COST REPORTING FISCAL YEAR PERIOD. THIS REPORT IS PROVIDED TO CMS WHEN EVER NECESSARY. MOST COMMONLY ATTACHED TO THE COST REPORT. PART VI, LINE 2: OHIO COUNTY HEALTHCARE PERFORMED A COMMUNITY NEEDS ASSESSMENT IN CONJUNCTION WITH THE GREEN RIVER DISTRICT HEALTH DEPARTMENT TO DETERMINE THE HEALTH NEEDS OF THE LOCAL COMMUNITY.THE SIGNIFICANT HEALTH NEEDS FOR OHIO COUNTY ARE:1. MENTAL HEALTH:VIOLENCE PREVENTION2. SUBSTANCE ABUSE: ALCOHOL, TOBACCO AND OTHER DRUGS3. HEALTHY LIFESTYLESTHE HOSPITAL HAS DEVELOPED IMPLEMENTATION STRATEGIES FOR THESE THREE NEEDS INCLUDING ACTIVITIES TO CONTINUE/PURSUE, COMMUNITY PARTNERS TO WORK ALONGSIDE, AND MEASURES TO TRACK PROGRESS.OCH USED THE PRIORITY RANKING OF AREA HEALTH NEEDS BY LOCAL EXPERT ADVISORS TO ORGANIZE THE SEARCH FOR LOCALLY AVAILABLE RESOURCES AS WELL AS THE RESPONSE TO THE NEEDS BY OCH.THE IMPLEMENTATION STRATEGY INCLUDES THE FOLLOWING:IDENTIFIES OHIO COUNTY HOSPITAL CURRENT EFFORTS RESPONDING TO THE NEED INCLUDING ANY WRITTEN COMMENTS RECEIVED REGARDING PRIOR OCH IMPLEMENTATION ACTIONS.ESTABLISHES THE IMPLEMTATION STRATEGY PROGRAMS AND RESOURCES OCH WILL DEVOTE TO ATTEMPT TO ACHIEVE IMPROVEMENTS.PRESENTS THE LOCALLY AVAILABLE RESOURCES NOTED DURING THE DEVELOPMENT OF THIS REPORT AS BELIEVED TO BE CURRENTLY AVAILABLE TO RESPOND TO THIS NEED. PART VI, LINE 3: OHIO COUNTY HOSPITAL'S ADMITTING AND BUSINESS OFFICE STAFF PROVIDES CHARITY CARE APPLICATIONS TO ANY PATIENT THAT DOESN'T HAVE INSURANCE DURING THE REGISTRATION PROCESS. IF THE PATIENT DOESN'T COMPLETE THE APPLICATION AT THAT TIME, THEIR DEMOGRAPHIC INFORMATION IS THEN SENT TO AN OUTSIDE COMPANY, DMC, INC, AND THEY DETERMINE IF THE PATIENT IS ELIGIBLE FOR EITHER MEDICAID OR CHARITY CARE. DMC WILL FOLLOW-UP WITH THE PATIENT TO GET ADDITIONAL INFORMATION AS NEEDED. ONCE THE ACCOUNT IS BILLED AND IS IN THE COLLECTION PROCESS, OUR PRIVATE PAY COUNSELORS CHECK EACH ACCOUNT TO MAKE SURE THAT IT HAS BEEN CHECKED FOR INDIGENT CARE ELIGIBILITY. PART VI, LINE 4: HISTORICALLY 90% OF ALL ADMISSIONS AND 95% OF ALL OUTPATIENT SERVICES PERFORMED AT OHIO COUNTY HOSPITAL ARE PROVIDED TO RESIDENTS OF OHIO COUNTY; 94% OF ALL MEDICARE INPATIENT ADMISSIONS ARE GENERATED FROM THE OHIO COUNTY AREA. THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES THE RESIDENTS OF THE INCORPORATED CITIES OF HARTFORD, BEAVER DAM, ROSINE, FORDSVILLE, HORSE BRANCH AND CROMWELL. OHIO COUNTY IS GEOGRAPHICALLY THE FIFTH LARGEST COUNTY IN KENTUCKY. TOTAL POPULATION AS OF 2015 WAS 21,488.OHIO COUNTY IS A DESIGNATED A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVICED AREA / POPULATION (MUA/P). IN 2015, THE PERCENTAGE OF OHIO COUNTY'S POPULATION LIVING BELOW THE POVERTY LEVEL DECREASED TO 19.70%. ACCORDING TO KENTUCKY HEALTH FACTS, THE RATE FOR UNINSURED ADULTS (UNDER 65 YEARS) IS 12.5%. PART VI, LINE 5: OHIO COUNTY HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS WHO ARE COMMITTED TO THE HEALTH AND WELFARE OF THE COMMUNITY AND DEDICATED TO ENSURING THE VIABILITY OF THE HOSPITAL FOR YEARS TO COME. THE BOARD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA. SURPLUS FUNDS PROVIDE FOR CONTINUITY OF HEALTHCARE SERVICES DURING PERIODS OF ECONOMIC DOWNTURN, RECRUITMENT OF ADDITIONAL PROVIDERS TO IMPROVE THE ACCESS TO HEALTHCARE, AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK AND SERVES ALL CITIZENS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDES REPRESENTATION AND SUPPORT TO THE OHIO COUNTY CHAMBER BOARD OF DIRECTORS, OHIO COUNTY TOURISM, OHIO COUNTY INDUSTRIAL FOUNDATION, AND LEADERSHIP OHIO COUNTY PROGRAM, WHICH ARE ORGANIZATIONS WORKING TOWARDS THE ECONOMIC GROWTH OF OUR AREA. PART VI, LINE 7, REPORTS FILED WITH STATES KY X X 0 0 0 0 0 0 0 0 0 MUKESH DESAI MEDICAL STAFF REPRESENTATI 600000 0 0 0 0 0 43000 0 16268 0 659268 0 0 0 JOSHUA SKIBBA CARDIOLOGIST/CMO 383342 0 0 0 0 0 36500 0 3332 0 423174 0 0 0 CHARLES RICCIO GASTROENTEROLOGIST 533037 0 0 0 0 0 42500 0 10536 0 586073 0 0 0 STEVEN MILLS PHYSICIAN 239266 0 272455 0 0 0 16723 0 3450 0 531894 0 0 0 ALEX ARGOTTE PHYSICIAN ER 679801 0 37500 0 0 0 23859 0 0 0 741160 0 0 0 BRUCE DURHAM PHYSICIAN 238871 0 29874 0 0 0 19000 0 5052 0 292797 0 0 0 BAILEY PHELPS MD PHYSICIAN 242369 0 78380 0 0 0 14504 0 6309 0 341562 0 0 0 A OHIO COUNTY PUBLIC FACILITIES CORPORATION 616000805 2010-09-29 3620000 MEDICAL OFFICE BUILDING CONSTRUCTION 0 0 0 A 3015000 271800 70000 2011 0 0 1 1 A 0 0 0 0 1 0 0 A 1 1 0 0 0 0 A 0 MICHELLE OSBORNE PHYSICIAN SIGNON BONUS X 5309 2359 0 1 1 NICOLE AKERS PHYSICIAN SIGNON BONUS X 20000 5000 0 1 1 BAILEY PHELPS PHYSICIAN SIGNON BONUS X 16001 4000 0 1 1 KRISTY DAVIDSON PHYSICIAN SIGNON BONUS X 2000 1250 0 1 1 JOHN JEFFRIES PHYSICIAN SIGNON BONUS X 30000 12803 0 1 1 CHRIS SAMPSON PHYSICIAN SIGNON BONUS X 10000 2500 0 1 1 ALEX ARGOTTE PHYSICIAN UNEARNED VACATION X 1500 1500 0 1 1 JENNA HAYNES PHYSICIAN UNEARNED VACATION X 1914 1914 0 1 1 TERRA ROBERTS PHYSICIAN UNEARNED VACATION X 2163 2163 0 1 1 33489 FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL CONTRACTS WITH QUORUM HEALTH RESOURCES, INC (QHR) TO PROVIDE MANAGEMENT SERVICES UNDER AN AGREEMENT WHICH EXPIRES IN 2024. THE CONTRACT REQUIRES QHR TO SUPPLY A CHIEF EXECUTIVE OFFICER AND A CHEIF FINANCIAL OFFICER WHOSE SALARY AND BENEFITS COST ARE PASSED DIRECTLY THROUGH TO THE HOSPITAL. THE HOSPITAL'S EXPENSE FOR THE MANAGEMENT FEE TOTALED APPOXIMATELY $293,828 FOR THIS YEAR. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ARE COVERED UNDER THIS POLICY AND ANY CONFLICTS ARE RESOLVED AT MONTHLY BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS RECEIVED A COMPENSATION REVIEW BY QHR AND THE GOVERNING BOARD. OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION RECEIVE ANNUAL REVIEWS BASED ON CURRENT MARKET DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,027,956. MANAGEMENT AND GENERAL EXPENSES 607,304. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,635,260. ER PHYSICIANS: PROGRAM SERVICE EXPENSES 1,126,232. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,126,232. PURCHASED SERVICES ADMINISTRATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 493,422. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 493,422. OHIO COUNTY PAIN MANAGEMENT LLC 1211 OLD MAIN STREET HARTFORD KY 42347 815391477 MEDICAL SERVICES PAIN MANAGEMENT KY OHIO COUNTY HOSPITAL CORPORATION RELATED 110651 220001 0 0 0.51000 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 OHIO COUNTY HOSPITAL PAIN MANAGEMENT LLC Q 890856 CASH OHIO COUNTY HOSPITAL PAIN MANAGEMENT LLC D 38285 CASH