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OHIO COUNTY HOSPITAL CORPORATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
OHIO COUNTY HOSPITAL CORPORATION (EIN 31-1131099)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-05-22
IRS object ID
202031439349300918
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-05-22T09:55:58-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN621046406PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON HICKEY & MURCHISON PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12215 OLAN MILLS DRIVEAddressLine1Txt
CityCHATTANOOGACityNm
State AbbreviationTNStateAbbreviationCd
ZIP37421ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311131099EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HOSPITAL CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlOHIOBusinessNameControlTxt
Phone2702987411PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1Txt
CityHARTFORDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42347ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHELLIE SHOUSEPersonNm
Person TitleCFOPersonTitleTxt
Phone2702987411PhoneNum
Signature2020-05-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBARRY R HUGGINSPreparerPersonNm
PTINP00627334PTIN
Phone4237560052PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address64.88.174.3IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-22IPDt
IP Tm09:42:53IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4D2F6FA112CA0D83A1A5F4FC7ED964A6D0BC4DD5AtSubmissionCreationDeviceId
At Submission Filing Device Id3272C60C25DFB1EC93670E56C0D89454EDAEBC1DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-22 18:59:49ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HEALTHCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSHELLIE SHOUSEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1Txt
CityHARTFORDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42347ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$44,899,777GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.OHIOCOUNTYHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionOHIO 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.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee578TotalEmployeeCnt
Total Volunteers35TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$29,141PYContributionsGrantsAmt
CY Contributions Grants$30,554CYContributionsGrantsAmt
PY Program Service Revenue$38,777,218PYProgramServiceRevenueAmt
CY Program Service Revenue$40,295,632CYProgramServiceRevenueAmt
PY Investment Income$22,435PYInvestmentIncomeAmt
CY Investment Income$128,158CYInvestmentIncomeAmt
PY Other Revenue$3,660,513PYOtherRevenueAmt
CY Other Revenue$4,445,433CYOtherRevenueAmt
PY Total Revenue$42,489,307PYTotalRevenueAmt
CY Total Revenue$44,899,777CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$22,759,129PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$23,257,860CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,337,387PYOtherExpensesAmt
CY Other Expenses$21,207,407CYOtherExpensesAmt
PY Total Expenses$42,096,516PYTotalExpensesAmt
CY Total Expenses$44,465,267CYTotalExpensesAmt
PY Revenues Less Expenses$392,791PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$434,510CYRevenuesLessExpensesAmt
Total Assets BOY$18,710,091TotalAssetsBOYAmt
Total Assets EOY$19,116,076TotalAssetsEOYAmt
Total Liabilities BOY$9,001,787TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,973,262TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,708,304NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,142,814NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOHIO 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$40,767,414ExpenseAmt
Revenue$44,741,065RevenueAmt
DescTHE 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 2019, THE HOSPITAL PROVIDED HEALTH CARE SERVICES TO OHIO COUNTY KENTUCKY AND SURROUNDING AREAS, INCLUDING INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. OHIO COUNTY HOSPITAL PROVIDED $429,686 OF CHARITY CARE THROUGH ITS CHARITY CARE PROGRAM.Desc
Total Program Service Expenses$40,767,414TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document43IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee578EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldKYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSHELLIE SHOUSEPersonNm
Phone2702985495PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1Txt
CityHARTFORDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42347ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JONATHAN SHREWSBURY OD
PRESIDENT2.00Yes (X)Yes (X)$0$0$0
JIM DUKE
SECRETARY/TREASURER2.00Yes (X)Yes (X)$0$0$0
KELLY ROE
DIRECTOR2.00Yes (X)$0$0$0
CARLA WALLACE
DIRECTOR2.00Yes (X)$0$0$0
GERALD WESTERFIELD
DIRECTOR2.00Yes (X)$0$0$0
LLOYD SPIVEY
VICE PRESIDENT2.00Yes (X)$0$0$0
KEVIN GREGORY MD
MEDICAL STAFF REPRESENTATI2.00Yes (X)$0$0$0
MARY COOK
DIRECTOR2.00Yes (X)$0$0$0
BAILEY PHELPS MD
MEDICAL STAFF REPRESENTATI2.00Yes (X)$271,978$0$12,157
JOSHUA SKIBBA
CARDIOLOGIST/CMO40.00Yes (X)$408,102$0$38,831
ATHENA MINOR
CHIEF CLINICAL OFFICER40.00Yes (X)$78,768$0$9,025
MUKESH DESAI
UROLOGIST40.00$601,000$0$48,138Yes (X)
CHARLES RICCIO
GASTROENTEROLOGIST40.00$553,099$0$55,780Yes (X)
STEVEN MILLS
PHYSICIAN40.00$321,258$0$19,639Yes (X)
JOEL JOHNSTON
PHYSICIAN ER40.00$317,626$0$17,455Yes (X)
BRUCE DURHAM
PHYSICIAN40.00$264,772$0$21,201Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,816,603TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$222,226TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ORTHAPAEDICS AND SPORTS MEDICINE
2831 NEW HARTFORD RDOWENSBOROKY42303ORTHOPEDIC SURGERIES$940,772
EMCARE PHYSICIAN SERVICES
7032 COLLECTION CENTER DRIVECHICAGOIL60693ER PHYSICIANS$319,067
QUOROM HEALTH RESOURCES
105 CONTINENTAL PLACEBRENTWOODTN37027MANAGEMENT FEES$284,328
GEORGE GILLIAM MD
2100 SOUTH STRATFORD DRIVEOWENSBOROKY42301PHYSICIAN SURGICAL$281,369
EXCEL ANESTHESIA PSC
1020 N MAIN STREETBEAVER DAMKY42320ANESTHESIA$169,688
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
All Other Contributions$30,554AllOtherContributionsAmt
Total Contributions$30,554TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICESDesc
Business621300BusinessCd
Total Revenue Column$40,295,632TotalRevenueColumnAmt
Related Or Exempt Func Income$40,295,632RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$40,295,632TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$128,158TotalRevenueColumnAmt
Exclusion$128,158ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS REVENUE611430$3,428,468$3,428,468
PAIN MANAGEMENT CENTER621400$589,952$589,952
CLINIC REVENUE621400$298,375$298,375

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$128,638TotalRevenueColumnAmt
Related Or Exempt Func Income$128,638RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$4,445,433OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,899,777TotalRevenueColumnAmt
Related Or Exempt Func Income$44,741,065RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$128,158ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$534,726TotalAmt
Program Services$534,726ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$19,893,950TotalAmt
Program Services$18,637,565ProgramServicesAmt
Management And General$1,256,385ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$201,670TotalAmt
Program Services$178,377ProgramServicesAmt
Management And General$23,293ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,201,311TotalAmt
Program Services$1,062,560ProgramServicesAmt
Management And General$138,751ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,426,203TotalAmt
Program Services$1,342,156ProgramServicesAmt
Management And General$84,047ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$284,328TotalAmt
Management And General$284,328ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$30,000TotalAmt
Management And General$30,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$114,789TotalAmt
Management And General$114,789ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,282,869TotalAmt
Program Services$4,317,544ProgramServicesAmt
Management And General$965,325ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$87,342TotalAmt
Program Services$87,342ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$147,337TotalAmt
Program Services$101,472ProgramServicesAmt
Management And General$45,865ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,035,096TotalAmt
Program Services$1,615,667ProgramServicesAmt
Management And General$419,429ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$93,776TotalAmt
Program Services$72,309ProgramServicesAmt
Management And General$21,467ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$37,723TotalAmt
Program Services$33,765ProgramServicesAmt
Management And General$3,958ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$158,433TotalAmt
Program Services$140,131ProgramServicesAmt
Management And General$18,302ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$797,012TotalAmt
Program Services$704,940ProgramServicesAmt
Management And General$92,072ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$576,616TotalAmt
Program Services$531,431ProgramServicesAmt
Management And General$45,185ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES AND DR$7,307,243$7,307,243
BAD DEBT$3,289,223$3,289,223
TAXES AND LICENSES$478,912$478,912
DUES AND SUBSCRIPTIONS$215,571$155,740$59,831

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$271,137TotalAmt
Program Services$176,311ProgramServicesAmt
Management And General$94,826ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$44,465,267TotalAmt
Program Services$40,767,414ProgramServicesAmt
Management And General$3,697,853ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,269,402BOYAmt
EOY$5,789,216EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$381,050BOYAmt
EOY$381,800EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,496,536BOYAmt
EOY$4,012,334EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$93,271EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,356,375BOYAmt
EOY$497,901EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$942,520BOYAmt
EOY$934,184EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$164,075BOYAmt
EOY$248,115EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$26,062,257LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$19,637,408LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,497,892BOYAmt
EOY$6,424,849EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$602,241BOYAmt
EOY$734,406EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,710,091BOYAmt
EOY$19,116,076EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,940,921BOYAmt
EOY$3,499,198EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,545,000BOYAmt
EOY$2,340,381EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,461,125BOYAmt
EOY$1,515,221EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,054,741BOYAmt
EOY$1,618,462EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,001,787BOYAmt
EOY$8,973,262EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,708,304BOYAmt
EOY$10,142,814EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,708,304BOYAmt
EOY$10,142,814EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,710,091BOYAmt
EOY$19,116,076EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$434,510ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,626OtherActivitiesAmt
Total Lobbying Expenditures$3,626TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL PAYS DUES TO THE KENTUCKY HOSPITAL ASSSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$530,032OtherCostOrOtherBasisAmt
Book Value$530,032BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,641,381OtherCostOrOtherBasisAmt
Depreciation$5,114,808DepreciationAmt
Book Value$3,526,573BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,403,639OtherCostOrOtherBasisAmt
Depreciation$14,089,924DepreciationAmt
Book Value$2,313,715BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$487,205OtherCostOrOtherBasisAmt
Depreciation$432,676DepreciationAmt
Book Value$54,529BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,424,849TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
THIRD PARTY SETTLEMENTS$968,008
RETIREMENT BENEFITS$650,454
FieldValueIRS element (for citing)
Total Liability$1,618,462TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$44,899,777TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$44,899,777RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$44,899,777TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$44,465,267TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$44,465,267ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$44,465,267TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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, 2019 AND 2018. AS OF SEPTEMBER 30, 2019 AND 2018, 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 2016.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$636,798TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$636,798NetCommunityBenefitExpnsAmt
Total Expense0.01550TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,087,796TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,221,132DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,866,664NetCommunityBenefitExpnsAmt
Total Expense0.04530TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,724,594TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,221,132DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,503,462NetCommunityBenefitExpnsAmt
Total Expense0.06080TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,554TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$33,554NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,554TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$33,554NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,758,148TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,221,132DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,537,016NetCommunityBenefitExpnsAmt
Total Expense0.06160TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,400,494BadDebtExpenseAmt
Bad Debt Expense Attributable$182,953BadDebtExpenseAttributableAmt
Reimbursed By Medicare$25,554,892ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,426,920CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$127,972MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HOSPITAL CORPORATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1Txt
CityHARTFORDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42347ZIPCd
FieldValueIRS element (for citing)
State License1629007430StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HOSPITAL CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.OHIOCOUNTYHOSPITAL.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.OHIOCOUNTYHOSPITAL.COMStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care100.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.OHIOCOUNTYHOSPITAL.COMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.OHIOCOUNTYHOSPITAL.COMFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.OHIOCOUNTYHOSPITAL.COMFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Other ActionsYes (X)PermitOtherActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
OHIO COUNTY HOSPITAL CORPORATIONPART V, SECTION B, LINE 5: GREEN RIVER DISTRICT UTILIZED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) TO CONDUCT THE 2015-2018 COMMUNITY HEALTH ASSESSMENT/COMMUNITY HEALTH IMPROVEMENT PLAN (CHA/CHIP). MAPP IS A COMMUNITY DRIVEN STRATEGIC PLANNING PROCESS DEVELOPED BY NACCHO AND THE CDC TO ASSIST COMMUNITIES IN ORGANIZING PARTNERS, COLLECTING COMPREHENSIVE DATA AND IMPLEMENTING AN ACTION PLAN. THE MAPP PROCESS INCLUDES SIX PHASES INCLUDING PARTNERSHIP DEVELOPMENT, VISIONING, ASSESSMENT,IDENTIFYING PRIORITY ISSUES, FORMULATING GOALS AND STRATEGIES AND TAKING ACTION.THE ASSESSMENT PORTION OF THE MAPP PROCESS INCLUDES FOUR DIFFERENT ASSESSMENTS; THEMES AND STRENGTHS ASSESSMENT, FORCES OF CHANGE ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, AND THE COMMUNITY HEALTH STATUS ASSESSMENT. PERCEPTIONS ABOUT QUALITY OF LIFE, LOCAL ASSETS AND ISSUES THAT INTEREST THE COMMUNITY CONTRIBUTED TO THE THEMES AND STRENGTHS ASSESSMENT. THE FORCES OF CHANGE ASSESSMENT IDENTIFIED TRENDS AND OTHER ISSUES THAT COULD IMPACT THE COMMUNITY. TO MEASURE PARTNERSHIP INVOLVEMENT AND DELIVERY OF SERVICES, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT WAS CONDUCTED. THE COMMUNITY HEALTH STATUS ASSESSMENT PROVIDED PRIMARY AND SECONDARY DATA ON THE COMMUNITY'S HEALTH CONDITIONS.
OHIO COUNTY HOSPITAL CORPORATIONPART V, SECTION B, LINE 6B: GREEN RIVER COMMUNITY DISTRICT HEALTH DEPARTMENT (DAVIESS, HANCOCK, HENDERSON, MCLEAN, OHIO, UNION,AND WEBSTER COUNTIES)
OHIO COUNTY HOSPITAL CORPORATIONPART 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 CORPORATIONPART 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 CORPORATIONPART 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.

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 $ 3,289,223.
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:GREEN RIVER DISTRICT UTILIZED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) TO CONDUCT THE 2015-2018 COMMUNITY HEALTH ASSESSMENT/COMMUNITY HEALTH IMPROVEMENT PLAN (CHA/CHIP). MAPP IS A COMMUNITY DRIVEN STRATEGIC PLANNING PROCESS DEVELOPED BY NACCHO AND THE CDC TO ASSIST COMMUNITIES IN ORGANIZING PARTNERS, COLLECTING COMPREHENSIVE DATA AND IMPLEMENTING AN ACTION PLAN.THE MAPP PROCESS INCLUDES SIX PHASES INCLUDING PARTNERSHIP DEVELOPMENT, VISIONING, ASSESSMENT, IDENTIFYING PRIORITY ISSUES, FORMULATING GOALS AND STRATEGIES AND TAKING ACTION.1. PARTNERSHIPS: DRAWING ON THE BROAD PARTICIPATION OF PARTNERS DURING THE PREVIOUS CYCLE (2012-2015), REPRESENTATIVES FROM LOCAL COALITIONS, HOSPITALS, HEALTHCARE PROVIDERS, GOVERNANCE AND EDUCATION AS WELL AS CONCERNED CITIZENS CAME TOGETHER TO PARTICIPATE IN THE MAPP PROCESS. IN ADDITION, PARTNER AGENCIES FROM THE PREPAREDNESS SECTOR FOCUSED ON BUILDING COMMUNITY RESILIENCE THROUGH MAPP.2. VISIONING: EACH COUNTY SELECTED A VISION STATEMENT TO GUIDE COMMUNITY HEALTH IMPROVEMENT PLAN DECISIONS. VISIONS WERE CREATED THROUGH CONSIDERATION OF MAPP ASSESSMENTS AND THE FOUR PERSPECTIVES; THESE VISIONS DESCRIBE AN IDYLLIC COMMUNITY.3. ASSESSMENT: THE ASSESSMENT PORTION OF THE MAPP PROCESS INCLUDES FOUR DIFFERENT ASSESSMENTS; THEMES AND STRENGTHS ASSESSMENT, FORCES OF CHANGE ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, AND THE COMMUNITY HEALTH STATUS ASSESSMENT. PERCEPTIONS ABOUT QUALITY OF LIFE,LOCAL ASSETS AND ISSUES THAT INTEREST THE COMMUNITY CONTRIBUTED TO THE THEMES AND STRENGTHS ASSESSMENT. THE FORCES OF CHANGE ASSESSMENT IDENTIFIED TRENDS AND OTHER ISSUES THAT COULD IMPACT THE COMMUNITY. TO MEASURE PARTNERSHIP INVOLVEMENT AND DELIVERY OF SERVICES, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT WAS CONDUCTED. THE COMMUNITY HEALTH STATUS ASSESSMENT PROVIDED PRIMARY AND SECONDARY DATA ON THE COMMUNITY'S HEALTH CONDITIONS. GREEN RIVER DISTRICT CONSIDERED FOUR PERSPECTIVES IN ASSESSING THE HEALTH OF OUR COMMUNITIES: DATA PERSPECTIVE: QUANTITATIVE DATA WAS USED TO DEVELOP A SOCIAL, ECONOMIC AND HEALTH PORTRAIT FOR EACH COUNTY. DATA WERE DRAWN FROM STATE, COUNTY AND LOCAL SOURCES INCLUDING KENTUCKY HEALTH FACTS, US CENSUS BUREAU DATA, COUNTY HEALTH RANKINGS, KENTUCKY DEPARTMENTFOR PUBLIC HEALTH AND THE KENTUCKY HEALTH BENEFIT EXCHANGE. FOR CURRENT HEALTH STATUS DETAILS,PLEASE SEE THE GRDHD 2015 COMMUNITY HEALTH ASSESSMENT AVAILABLE THROUGH WWW.HEALTHDEPARTMENT.ORG.ORGANIZATIONAL PERSPECTIVE: QUALITATIVE DATA WAS DERIVED FROM FORUMS AND FOCUS GROUPS CONDUCTED IN EACH COUNTY THROUGHOUT THE DISTRICT. A WIDE RANGE OF ORGANIZATIONS, COMMUNITY STAKEHOLDERS AND RESIDENTS SHARED THEIR PERCEPTIONS OF COMMUNITY, HEALTH CONCERNS, AND SERVICES, PROGRAMS AND EVENTS NECESSARY TO ADDRESS THOSE CONCERNS. DURING EACH OF THE FORUMS, LOCAL HEALTH INDICATORS WERE PRESENTED ALONG WITH THE COMMUNITY SURVEY AND PREVIOUS CYCLE INITIATIVES; ATTENDEES PARTICIPATED IN A DIALOGUE AROUND THE HEALTH AND THEIR COMMUNITY. THE ORGANIZATIONAL PERSPECTIVE EXPLORED CURRENT HEALTH PRIORITIES, IDENTIFIED STRENGTHS AND LOCAL RESOURCES, NOTED POTENTIAL FORCES OF CHANGE AND GAPS IN SERVICES. THE ORGANIZATIONAL PERSPECTIVE IS KEY TO INFORMING FUNDING AND PROGRAM PRIORITIES.INDIVIDUAL/HOUSEHOLD PERSPECTIVE: TO GATHER INFORMATION ABOUT ITS POPULATION, GRDHD CONDUCTED A COMMUNITY ASSESSMENT FOR PUBLIC HEALTH EMERGENCY RESPONSE (CASPER). THIS COMMUNITY SURVEY SUPPLIED ANSWERS TO QUESTIONS REGARDING PERCEIVED HEALTH OF THE COMMUNITY, STRENGTHS, WEAKNESSES, SPECIFIC HEALTH DIAGNOSES, ENVIRONMENTAL ISSUES AND LEVEL OF "PREPAREDNESS" IN THE CASE OF AN EMERGENCY OR NATURAL DISASTER. FOR MORE INFO SEE THE CASPER(COMMUNITY SURVEY) DATA SHEET AVAILABLE AT WWW.HEALTHDEPARTMENT.ORGFOCUS GROUPS AND SURVEYS: ALTHOUGH THE COMMUNITY SURVEY CAPTURED OPINIONS FROM A REPRESENTATIVE SAMPLE, THE NEEDS OF DISPARATE POPULATIONS MAY NOT HAVE BEEN ADEQUATELY COVERED. FOCUS GROUPS WERE SCHEDULED FOR EACH OF THE SEVEN COUNTIES TO ELICIT INPUT FROM LOW INCOME, TRANSIENT AND MINORITY POPULATIONS. A LACK OF INTEREST AND PARTICIPATION CONFINED THE RESULTS TO DAVIESS COUNTY. DISCUSSIONS EXPLORED PARTICIPANTS' PERCEPTIONS OF THEIR COMMUNITIES, PRIORITY HEALTH CONCERNS AND PERCEPTIONS OF HEALTH, PREVENTION AND HEALTHCARE SERVICES AS WELL AS SUGGESTIONS FOR SERVICES AND PROGRAMMING TO ADDRESS THESE ISSUES. PLEASE SEE THE (DAVIESS COUNTY SPECIAL POPULATIONS ADDENDUM TO THE GREEN RIVER COMMUNITY HEALTH ASSESSMENT) FOR MORE INFORMATION.HISTORICAL PERSPECTIVE / 2012-2015 CHA/CHIP: GREEN RIVER DISTRICT INITIATED THE MAPP PROCESS IN JANUARY 2012. LOCAL PARTNERS IN EACH OF THE SEVEN COUNTIES CAME TOGETHER TO ASSESS THEIR RESPECTIVE COMMUNITY'S HEALTH USING INPUT GATHERED USING A THREE PRONG APPROACH OF HEALTH DATA,PUBLIC OPINION (COMMUNITY SURVEY) AND PARTNERSHIP CONTRIBUTIONS (IN-DEPTH CONVERSATION IN COUNTY-SPECIFIC FOCUS GROUPS). THISINFORMATION WAS USED TO DEVELOP THE 2012-2015 CHIP. EACH COUNTY SELECTED THREE-FOUR STRATEGIC INITIATIVES TO ADDRESS OVER THE THREEYEAR CYCLE. LOCAL PARTNERS MET MONTHLY AND PURSUED OBJECTIVES TO IMPACT THEIR COMMUNITIES DIRECTLY. DISTRICT WIDE REPORTS WERECOMPLETED SEMI-ANNUALLY; A PUBLIC HEALTH FORUM EACH SPRING AND ANNUAL SUMMARY DOCUMENT EACH FALL. THE CHA IS AVAILABLE AT WWW.HEALTHDEPARTMENT.ORG. FLASH DRIVES WITH 2012-2015 INFORMATION AS WELL AS THE 2015 CHA WAS MADE AVAILABLE TO PUBLIC AND COMMUNITY PARTNERS THROUGHOUT THE CYCLE. POSTCARDS ANNOUNCING AVAILABILITY OF CHA RESULTS THROUGH THE HEALTH DEPARTMENT WEBSITE WERE PROVIDED TO LOCAL BUSINESSES THROUGHOUT THE DISTRICT.
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 STATESKY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BAILEY PHELPS MD
MEDICAL STAFF REPRESENTATI$224,964$0$47,014$0$0$0$6,215$0$5,942$0$284,135$0$0$0
JOSHUA SKIBBA
CARDIOLOGIST/CMO$408,102$0$0$0$0$0$33,792$0$5,039$0$446,933$0$0$0
MUKESH DESAI
UROLOGIST$601,000$0$0$0$0$0$42,000$0$6,138$0$649,138$0$0$0
CHARLES RICCIO
GASTROENTEROLOGIST$520,872$0$32,227$0$0$0$50,077$0$5,703$0$608,879$0$0$0
STEVEN MILLS
PHYSICIAN$233,285$0$87,973$0$0$0$16,309$0$3,330$0$340,897$0$0$0
JOEL JOHNSTON
PHYSICIAN ER$317,626$0$0$0$0$0$9,441$0$8,014$0$335,081$0$0$0
BRUCE DURHAM
PHYSICIAN$215,744$0$49,028$0$0$0$18,000$0$3,201$0$285,973$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY PUBLIC FACILITIES CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN616000805BondIssuerEIN
Bond Issued2010-09-29BondIssuedDt
Issue Price$3,620,000IssuePriceAmt
PurposeMEDICAL OFFICE BUILDING CONSTRUCTIONPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$3,015,000TotalProceedsAmt
In Reserve Fund$271,800InReserveFundAmt
Issuance Costs From Proceeds$70,000IssuanceCostsFromProceedsAmt
Substantial Completion2011SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestYes (1)BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledYes (1)Form8038TFiledInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (6 entries)

Loan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
MICHELLE OSBORNE
PHYSICIAN SIGNON BONUSYes (X)$5,309$4,1290Yes (1)Yes (1)
NICOLE AKERS
PHYSICIAN SIGNON BONUSYes (X)$25,000$25,0000Yes (1)Yes (1)
BAILEY PHELPS
PHYSICIAN SIGNON BONUSYes (X)$7,500$7,5000Yes (1)Yes (1)
ENTERPRISE MEDICAL RECRUITING
PHYSICIAN SIGNON BONUSYes (X)$21,000$21,0000Yes (1)Yes (1)
JOHN JEFFRIES
PHYSICIAN SIGNON BONUSYes (X)$30,000$30,0000Yes (1)Yes (1)
ARGOTTE MALPRACTICE PREMIUMS
PHYSICIAN SIGNON BONUSYes (X)$5,642$5,6420Yes (1)Yes (1)
FieldValueIRS element (for citing)
Total Balance Due$93,271TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE 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 $284,328 FOR THIS YEAR.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FORM 990 IS PROVIDED TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF DIRECTORS ARE COVERED UNDER THIS POLICY AND ANY CONFLICTS ARE RESOLVED AT MONTHLY BOARD MEETINGS.
FORM 990, PART VI, SECTION B, LINE 15THE 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 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,314,261. MANAGEMENT AND GENERAL EXPENSES 444,060. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,758,321. ER PHYSICIANS: PROGRAM SERVICE EXPENSES 1,003,283. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,003,283. PURCHASED SERVICES ADMINISTRATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 521,265. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 521,265.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY PAIN MANAGEMENT LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1Txt
CityHARTFORDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42347ZIPCd
FieldValueIRS element (for citing)
EIN815391477EIN
Primary ActivitiesMEDICAL SERVICES PAIN MANAGEMENTPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HOSPITAL CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$138,417ShareOfTotalIncomeAmt
Share Of EOY Assets$200,386ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.51000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
OHIO COUNTY HOSPITAL PAIN MANAGEMENT LLC
Q$959,328CASH
OHIO COUNTY HOSPITAL PAIN MANAGEMENT LLC
C$230,171CASH
OHIO COUNTY HOSPITAL PAIN MANAGEMENT LLC
D$58,135CASH