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HARRISON MEMORIAL HOSPITAL: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
HARRISON MEMORIAL HOSPITAL (EIN 61-0420440)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-07-26
IRS object ID
201812079349300201
Schema version
2016v3.0
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)
Return2018-07-26T06:58:52-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN273858252PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DEAN DORTON ALLEN FORD PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1106 W VINE STREET SUITE 600AddressLine1Txt
CityLEXINGTONCityNm
State AbbreviationKYStateAbbreviationCd
ZIP40507ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN610420440EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHARRBusinessNameControlTxt
Phone8592353502PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EAddressLine1Txt
CityCYNTHIANACityNm
State AbbreviationKYStateAbbreviationCd
ZIP410317498ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHEILA CURRANSPersonNm
Person TitleCEOPersonTitleTxt
Phone8592353502PhoneNum
Signature2018-07-19SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonALLISON C CARTERPreparerPersonNm
PTINP01242412PTIN
Phone8592552341PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSHEILA CURRANSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EAddressLine1Txt
CityCYNTHIANACityNm
State AbbreviationKYStateAbbreviationCd
ZIP410317498ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$57,588,015GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HARRISONMEMHOSP.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1906FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionTO PROVIDE HIGH QUALITY HEALTH AND MEDICAL CARE TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee550TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$35,825PYContributionsGrantsAmt
CY Contributions Grants$40,619CYContributionsGrantsAmt
PY Program Service Revenue$48,364,900PYProgramServiceRevenueAmt
CY Program Service Revenue$56,247,192CYProgramServiceRevenueAmt
PY Investment Income$56,235PYInvestmentIncomeAmt
CY Investment Income$80,546CYInvestmentIncomeAmt
PY Other Revenue$745,665PYOtherRevenueAmt
CY Other Revenue$938,559CYOtherRevenueAmt
PY Total Revenue$49,202,625PYTotalRevenueAmt
CY Total Revenue$57,306,916CYTotalRevenueAmt
PY Grants And Similar Paid$15,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$548CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,415,174PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$28,885,178CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,711,321PYOtherExpensesAmt
CY Other Expenses$26,429,808CYOtherExpensesAmt
PY Total Expenses$47,141,995PYTotalExpensesAmt
CY Total Expenses$55,315,534CYTotalExpensesAmt
PY Revenues Less Expenses$2,060,630PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,991,382CYRevenuesLessExpensesAmt
Total Assets BOY$58,796,216TotalAssetsBOYAmt
Total Assets EOY$65,449,580TotalAssetsEOYAmt
Total Liabilities BOY$37,204,001TotalLiabilitiesBOYAmt
Total Liabilities EOY$42,061,998TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,592,215NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$23,387,582NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHARRISON MEMORIAL HOSPITAL EXISTS FOR THE PURPOSE OF PROVIDING HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES OF OUR REGION WITHIN THE CAPABILITIES OF OUR RESOURCES. IN FULFILLING THIS MISSION, WE STRIVE FOR EXCELLENCE IN: THE CARE WE DELIVER; IN PATIENT SAFETY; IN THE FACILITIES WE PROVIDE; IN THE RECRUITMENT, RETENTION, AND DEVELOPMENT OF DEDICATED PHYSICIANS AND PERSONNEL; IN FACILITATING, COORDINATING AND PROVIDING ACCESS TO GENERAL AND SPECIALIZED HEALTH SERVICES THROUGH OUR OWN RESOURCES AND IN COLLABORATION WITH THE RESOURCES OF OTHERS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$48,960,554ExpenseAmt
Grant$548GrantAmt
Revenue$56,310,864RevenueAmt
DescTHE HOSPITAL PROVIDED HEALTH CARE TO 1,469 IN-PATIENTS, 188 NURSERY PATIENTS AND 70,195 OUT-PATIENTS. THE HOSPITAL HAS A HIGH VOLUME OF MEDICARE AND MEDICAID PATIENTS. THE HOSPITAL TREATS ALL PATIENTS REGARDLESS OF ABILITY TO PAY. HARRISON MEMORIAL HOSPITAL PROVIDED APPROXIMATELY $763,000 OF CHARITY CARE AT COST.Desc
Total Program Service Expenses$48,960,554TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
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 Footnote0IncludeFIN48FootnoteInd
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 Outstanding0LoanOutstandingInd
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 Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document87IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee550EmployeeCnt
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
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
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 Body0Form990ProvidedToGvrnBodyInd
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

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8592353502PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EAddressLine1Txt
CityCYNTHIANACityNm
State AbbreviationKYStateAbbreviationCd
ZIP410317498ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ALEX BARNETT
DIRECTOR1.00Yes (X)$0$0$0
STEPHEN BESSON
CHAIRMAN ELECT1.00Yes (X)$0$0$0
PATRICK DARNELL
DIRECTOR1.00Yes (X)$0$0$0
DR GERALD HARPEL
CHIEF OF MEDICAL STAFF40.00Yes (X)$387,211$0$16,457
HARLAND HATTER
DIRECTOR1.00Yes (X)$0$0$0
STEVE JUDY
CHAIRMAN1.00Yes (X)$0$0$0
FRAZER LEBUS
DIRECTOR1.00Yes (X)$0$0$0
DR BRIAN MULBERRY
DIRECTOR1.00Yes (X)$0$0$0
JAMES SMITH
DIRECTOR1.00Yes (X)$0$0$0
PAUL TUCKER
DIRECTOR1.00Yes (X)$0$0$0
GREG WILLS
DIRECTOR1.00Yes (X)$0$0$0
SHEILA CURRANS
CEO40.00$217,421$0$23,018Yes (X)
DAVID MELLETT
CFO40.00$135,024$0$29,370Yes (X)
JERROD DAVIS
COO40.00$127,983$0$29,150Yes (X)
TRACI TAYLOR
CNO40.00$94,765$0$13,037Yes (X)
DR MATTHEW SHOTWELL
CARDIOLOGIST40.00$1,291,161$0$15,191Yes (X)
DR JAMES PETTEY
ORTHO SURGEON40.00$521,374$0$2,522Yes (X)
DR DEREK CLARKE
OB/GYN40.00$371,226$0$39,912Yes (X)
DR TODD REID
SURGEON40.00$246,124$0$18,093Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,392,289TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$186,750TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
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
MESSER CONSTRUCTION CO
5158 FISHWICK DRIVECINCINNATIOH45216CONSTRUCTION MANAGEMENT$4,577,141
PARKE PHYSICIANS
155 E MARKET STREET SUITE 700INDIANAPOLISIN46204ER PHYSICIANS$1,643,446
MEDICAL INFORMATION TECHNOLOGY
MEDITECH CIRLEWESTWOODMA02090SOFTWARE TRAINING & IMPLEMENTATION$1,151,528
COMMUNITY ANESTHESIA OF THE BLUEGRASS
1210 KY HWY 36 E SUITE 152CYNTHIANAKY41031ANESTHESIA SERVICES$804,051
UMR ADMIN
11 SCOTT STREETWAUSAUWI54403HEALTH PLANS ADMINISTRATION$753,552
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K20CntrctRcvdGreaterThan100KCnt
All Other Contributions$40,619AllOtherContributionsAmt
Total Contributions$40,619TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business623990BusinessCd
Total Revenue Column$56,247,192TotalRevenueColumnAmt
Related Or Exempt Func Income$56,247,192RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$56,247,192TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$264,978TotalRevenueColumnAmt
Exclusion$264,978ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$108,746RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$96,667RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$12,079RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,079TotalRevenueColumnAmt
Exclusion$12,079ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$184,432OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$184,432OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$184,432TotalRevenueColumnAmt
Exclusion-$184,432ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
DAY CARE624410$327,221$327,221
CAFETERIA/VENDING722210$290,327$290,327
PURCHASE DISCOUNTS900099$135,434$135,434

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$173,498TotalRevenueColumnAmt
Related Or Exempt Func Income$63,672RelatedOrExemptFuncIncomeAmt
Exclusion$109,826ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$926,480OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$57,306,916TotalRevenueColumnAmt
Related Or Exempt Func Income$56,310,864RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$955,433ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$548TotalAmt
Program Services$548ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$777,583TotalAmt
Program Services$676,575ProgramServicesAmt
Management And General$101,008ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$23,599,160TotalAmt
Program Services$20,533,629ProgramServicesAmt
Management And General$3,065,531ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$416,377TotalAmt
Program Services$362,290ProgramServicesAmt
Management And General$54,087ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,516,291TotalAmt
Program Services$2,189,425ProgramServicesAmt
Management And General$326,866ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,575,767TotalAmt
Program Services$1,371,075ProgramServicesAmt
Management And General$204,692ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$49,630TotalAmt
Management And General$49,630ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,869,340TotalAmt
Program Services$5,106,913ProgramServicesAmt
Management And General$762,427ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$190,199TotalAmt
Program Services$165,492ProgramServicesAmt
Management And General$24,707ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$250,867TotalAmt
Program Services$218,279ProgramServicesAmt
Management And General$32,588ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$56,398TotalAmt
Program Services$49,072ProgramServicesAmt
Management And General$7,326ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$639,033TotalAmt
Program Services$556,023ProgramServicesAmt
Management And General$83,010ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$38,807TotalAmt
Program Services$33,766ProgramServicesAmt
Management And General$5,041ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$534,065TotalAmt
Program Services$534,065ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,433,774TotalAmt
Program Services$2,433,774ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$708,587TotalAmt
Program Services$616,542ProgramServicesAmt
Management And General$92,045ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS & SUPPLIES$9,127,273$8,067,825$1,059,448
BAD DEBT EXPENSE$2,359,678$2,359,678
OUTSOURCING$2,091,204$1,819,557$271,647
KY PROVIDER TAX$549,803$549,803

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,531,150TotalAmt
Program Services$1,316,223ProgramServicesAmt
Management And General$214,927ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$55,315,534TotalAmt
Program Services$48,960,554ProgramServicesAmt
Management And General$6,354,980ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,350,325BOYAmt
EOY$7,701,882EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,206,288BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,179,603BOYAmt
EOY$7,478,997EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,288,238BOYAmt
EOY$1,713,512EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,166,341BOYAmt
EOY$1,294,931EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$926,098BOYAmt
EOY$1,035,631EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$70,985,452LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$33,031,504LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$31,602,303BOYAmt
EOY$37,953,948EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,485,242BOYAmt
EOY$6,587,684EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$325,000BOYAmt
EOY$325,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,266,778BOYAmt
EOY$1,357,995EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$58,796,216BOYAmt
EOY$65,449,580EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,897,223BOYAmt
EOY$5,001,218EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,065,000BOYAmt
EOY$32,065,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$874,916BOYAmt
EOY$2,957,551EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$366,862BOYAmt
EOY$2,038,229EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$37,204,001BOYAmt
EOY$42,061,998EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,873,318BOYAmt
EOY$22,668,685EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$718,897BOYAmt
EOY$718,897EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,592,215BOYAmt
EOY$23,387,582EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$58,796,216BOYAmt
EOY$65,449,580EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,991,382ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$102,440NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$298,455OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$5,501OtherActivitiesAmt
Total Lobbying Expenditures$5,501TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE KENTUCKY HOSPITAL ASSOCIATION AND PAID DUES OF $30,341 OF WHICH $5,501 IS ATTRIBUTABLE TO LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$333,371OtherCostOrOtherBasisAmt
Book Value$333,371BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,792,190OtherCostOrOtherBasisAmt
Depreciation$11,183,730DepreciationAmt
Book Value$21,608,460BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$530,827OtherCostOrOtherBasisAmt
Depreciation$191,842DepreciationAmt
Book Value$338,985BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,133,504OtherCostOrOtherBasisAmt
Depreciation$20,713,029DepreciationAmt
Book Value$12,420,475BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,195,560OtherCostOrOtherBasisAmt
Depreciation$942,903DepreciationAmt
Book Value$3,252,657BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$37,953,948TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYORS$1,724,365
PHYSICIAN COMMITMENTS$313,864
FieldValueIRS element (for citing)
Total Liability$2,038,229TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$55,146,345TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$102,440NetUnrealizedGainsInvstAmt
Other Revenue$96,667OtherRevenueAmt
Revenue Not Reported$199,107RevenueNotReportedAmt
Revenue Subtotal$54,947,238RevenueSubtotalAmt
Other Revenues Not Included$2,359,678OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,359,678RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$57,306,916TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$53,052,523TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$96,667OtherExpensesIncludedAmt
Expenses Not Reported$96,667ExpensesNotReportedAmt
Expenses Subtotal$52,955,856ExpensesSubtotalAmt
Other Expenses Not Included$2,359,678OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,359,678ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$55,315,534TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NETTED AGAINST RENTAL INCOME ON PAGE 1 96,667.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE NETTED ON FINANCIALS 2,359,678.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NETTED AGAINST RENTAL INCOME ON PAGE 1 96,667.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE NETTED ON FINANCIALS 2,359,678.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other150.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$168,073TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$168,073NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,167,219TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,397,263DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,769,956NetCommunityBenefitExpnsAmt
Total Expense0.05010TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,335,292TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,397,263DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,938,029NetCommunityBenefitExpnsAmt
Total Expense0.05310TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$389,300TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$389,300NetCommunityBenefitExpnsAmt
Total Expense0.00700TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$548TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$548NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$389,848TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$389,848NetCommunityBenefitExpnsAmt
Total Expense0.00700TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,725,140TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,397,263DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,327,877NetCommunityBenefitExpnsAmt
Total Expense0.06010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,377,589BadDebtExpenseAmt
Reimbursed By Medicare$9,958,891ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,975,470CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,016,579MedicareSurplusOrShortfallAmt

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 Line1HARRISON MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EASTAddressLine1Txt
CityCYNTHIANACityNm
State AbbreviationKYStateAbbreviationCd
ZIP41031ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL HOSPITAL INCBusinessNameLine1Txt
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
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.HARRISONMEMHOSP.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.HARRISONMEMHOSP.COMStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care150.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.HARRISONMEMHOSP.COMFAPAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
HARRISON MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 5: INDIVIDUALS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH WERE INTERVIEWED DURING THE COURSE OF PREPARING THE COMMUNITY NEEDS ASSESSMENT. THESE INDIVIDUALS INCLUDED BOTH FAMILY SPECIALTY PHYSICIANS AND DIRECTORS OF LOCAL HEALTH DEPARTMENTS OF HARRISON COUNTY AND THE SURROUNDING COUNTIES AND THE MAYOR OF CYNTHIANA.
HARRISON MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 11: THE HOSPITAL HAS ADDRESSED THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH ITS IMPLEMENTATION PLAN THAT IS POSTED ON THE HOSPITAL'S WEBSITE AND ATTACHED TO THIS RETURN.

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:AMOUNTS WERE DETERMINED USING A COST-TO-CHARGE RATIO DERIVED FROM THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H.
PART I, LN 7 COL(F):$2,377,589 OF BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A) WAS REMOVED FROM THE DENOMINATOR OF THIS CALCULATION PER THE INSTRUCTIONS.
PART II, COMMUNITY BUILDING ACTIVITIES:HARRISON MEMORIAL HOSPITAL IS VERY ACTIVE IN THE COMMUNITY WITH PROMOTING HEALTH EDUCATION. HMH PARTNERS WITH SEVERAL COMMUNITY ORGANIZATIONS TO REACH THE LARGEST AUDIENCE. IN MOST RECENT YEARS, HMH HAS PROVIDED HEALTH FAIRS AND SEMINARS IN SEVERAL COUNTIES LIKE PENDLETON, BRACKEN AND ROBERTSON. BY PROVIDING THESE EVENTS, HMH IS ABLE TO PROVIDE EDUCATION AND SCREENINGS MORE LOCALLY FOR THE RESIDENTS. IN ADDITION, THE EVENTS AID IN BUILDING RELATIONSHIPS WITH COMMUNITY LEADERS AND RESIDENTS. THE EVENTS LIKE HEALTH FAIRS PROVIDE FREE TESTS AND SCREENINGS, WHICH WOULD NORMALLY COST $1200 PER PERSON. THE HEALTH FAIRS PROVIDE AN OPPORTUNITY FOR THE UNDERINSURED AND UNINSURED TO RECEIVE MEDICAL CARE. THE EVENTS ALSO HAVE SEVERAL OPPORTUNITIES TO MEET WITH HEALTH CARE PROFESSIONALS TO DISCUSS HEALTH ISSUES. THE HMH SPONSORED EDUCATIONAL SEMINARS PROVIDE AN OPPORTUNITY FOR INDIVIDUALS TO MEET HEALTH CARE PROFESSIONALS AND DISCUSS MAJOR HEALTH TOPICS.
PART III, LINE 2:BAD DEBT COST REPRESENTS THE EXPENSE THE HOSPITAL INCURRED DUE TO NONPAYMENT OF HOSPITAL CHARGES INCLUDING, BUT NOT LIMITED TO, NONPAYMENT OF MEDICARE COINSURANCE AND DEDUCTIBLE AMOUNTS. THIS EXPENSE IS LISTED AS CONTRA-REVENUE IN THE FINANCIAL STATEMENTS.BAD DEBT COST IS CALCULATED BY MULTIPLYING THE BAD DEBT EXPENSE LISTED ON THE FINANCIAL STATEMENTS BY THE COST TO CHARGE RATIO COMPUTED ON WORKSHEET 2.
PART III, LINE 8:ALL THE SHORTFALL REPORTED IN LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. LINE 6 WAS COMPUTED USING REVENUE AMOUNTS LISTED ON THE SETTLEMENT WORKSHEETS ON THE AS-FILED MEDICARE COST REPORT.
PART III, LINE 9B:THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE BASED ON FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AND DISCOUNTED CARE. FOR PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WITH DISCOUNTED CARE, COLLECTION PURSUITS FOR THE DISCOUNTED CHARGES ARE FOLLOWED AS STATED IN OUR PROMPT PAYMENT ON SELF-PAY ACCOUNTS POLICY.
PART VI, LINE 2:THE HOSPITAL COMPLETED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. IN ADDITION, HARRISON MEMORIAL HOSPITAL ASSESSES THE COMMUNITY THROUGH SEVERAL METHODS. THE HMH COMMUNITY CONSISTS OF A SEVEN-COUNTY AREA. HMH HAS TWO BOARD LEVEL COMMITTEES WHO PROVIDE RECOMMENDATIONS TO THE HMH BOARD OF DIRECTORS. PLANNING: MARKET SHARE ENHANCEMENT COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS AND HMH PHYSICIAN STAFF MEMBERS. THE COMMITTEE IS PRESENTED WITH MARKET SHARE DATA OF THE INPATIENT ACTIVITY OF THE HOSPITAL AND OF MAJOR SERVICE LINES LIKE CARDIOLOGY, ORTHOPEDICS. THE DATA INFORMS THE COMMITTEE WHERE PATIENTS IN THE HMH SERVICE AREA CHOOSE TO RECEIVE HEALTHCARE. THE DATA IS EXTRACTED FROM KENTUCKY INFOSUITE EACH QUARTER. THE REPORTS AID THE COMMITTEE IN MAKING DECISIONS IN REGARDS TO THE NEEDS OF THE COMMUNITY. EACH YEAR THE PMSE COMMITTEE HOSTS A STRATEGIC RETREAT INVITING HMH BOARD MEMBERS, PHYSICIAN STAFF MEMBERS AND SENIOR MANAGEMENT TO DISCUSS COMMUNITY NEEDS AND PLANS FOR THE FUTURE. ANOTHER BOARD LEVEL COMMITTEE IS CALLED MEDICAL STAFF DEVELOPMENT. THE COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS, HMH PHYSICIAN STAFF MEMBERS AND COMMUNITY VOLUNTEERS. EACH YEAR THE MEDICAL STAFF DEVELOPMENT COMMITTEE COMPLETES A PHYSICIAN NEEDS ASSESSMENT. THE ASSESSMENT DEMONSTRATES THE PHYSICIAN NEED IN THE AREA BASED ON POPULATION. THE ASSESSMENT IS USED TO FORM A PHYSICIAN RECRUITING PLAN FOR THE FUTURE AND IS RECOMMENDED TO THE BOARD FOR APPROVAL. FINALLY, THE HMH MEDICAL STAFF MEETINGS ARE HELD ONCE A MONTH WHERE MEMBERS OF THE HMH SENIOR MANAGEMENT ALSO ATTEND. WITHIN THESE MEETINGS, THE STAFF MEMBERS DISCUSS PATIENT NEEDS. THE INFORMATION GATHERED AT THESE MEETINGS AID IN THE DECISIONS OF SERVICE LINE ENHANCEMENT.
PART VI, LINE 3:NOTIFICATION ABOUT CHARITY AVAILABLE FROM HARRISON MEMORIAL HOSPITAL, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY HARRISON MEMORIAL HOSPITAL BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, SPECIALTY PHYSICIAN CLINICS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES, AND PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES AS HARRISON MEMORIAL HOSPITAL MAY ELECT. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY HARRISON MEMORIAL HOSPITAL. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE HARRISON MEMORIAL HOSPITAL STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.
PART VI, LINE 4:HARRISON MEMORIAL HOSPITAL SERVES SEVEN COUNTIES IN THE CENTRAL KENTUCKY AREA MAKING IT A REGIONAL FACILITY. THOSE COUNTIES ARE HARRISON, PENDLETON, ROBERTSON, BRACKEN, NICHOLAS, BOURBON AND SCOTT. HMH COMMUNITY IS CONSIDERED IN MOST PARTS RURAL WITH CYNTHIANA BEING ITS LARGEST TOWN IT SERVES WITH A POPULATION AROUND 7,000. THE AREA IS ALSO DESCRIBED AS A BEDROOM COMMUNITY OF LEXINGTON. THE AREA IS A FARMING COMMUNITY WITH SEVERAL STRONG INDUSTRIES BASED IN THE AREA. HMH CONSIDERS ITS SERVICE AREA POPULATION TO BE 35,000. THE DEMOGRAPHIC OF THE COMMUNITIES IS PREDOMINANTLY CAUCASIAN WITH AN AGING POPULATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
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 (8 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
DR GERALD HARPEL
CHIEF OF MEDICAL STAFF$387,211$0$0$0$0$0$0$0$16,457$0$403,668$0$0$0
SHEILA CURRANS
CEO$217,421$0$0$0$0$0$6,561$0$16,457$0$240,439$0$0$0
DAVID MELLETT
CFO$135,024$0$0$0$0$0$5,458$0$23,912$0$164,394$0$0$0
JERROD DAVIS
COO$127,983$0$0$0$0$0$5,238$0$23,912$0$157,133$0$0$0
DR MATTHEW SHOTWELL
CARDIOLOGIST$1,291,161$0$0$0$0$0$3,099$0$12,092$0$1,306,352$0$0$0
DR JAMES PETTEY
ORTHO SURGEON$521,374$0$0$0$0$0$2,522$0$0$0$523,896$0$0$0
DR DEREK CLARKE
OB/GYN$371,226$0$0$0$0$0$16,000$0$23,912$0$411,138$0$0$0
DR TODD REID
SURGEON$246,124$0$0$0$0$0$9,030$0$9,063$0$264,217$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 Line1COUNTY OF HARRISON KYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN616000746BondIssuerEIN
Bond Issued2015-11-01BondIssuedDt
Issue Price$32,065,000IssuePriceAmt
PurposeFINANCE CAPITAL EXPENDITURES AND REFUND PREVIOUS BONDSPurposeDesc
DefeasedYes (1)DefeasedInd
On Behalf Of IssuerYes (1)OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$32,065,000TotalProceedsAmt
Capitalized Interest$482,810CapitalizedInterestAmt
Refunding Escrow$15,299,328RefundingEscrowAmt
Issuance Costs From Proceeds$547,881IssuanceCostsFromProceedsAmt
Capital Expenditures$11,020,761CapitalExpendituresAmt
Unspent$4,714,220UnspentAmt
Current Refunding0CurrentRefundingInd
Advance RefundingYes (1)AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
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 Test0BondIssMeetPrvtSecPymtTestInd
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 ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS REVIEWED, AFTER FILING, IN DETAIL AT THE FINANCE COMMITTEE MEETING WITH BOARD MEMBERS PRESENT. THEY ARE ASKED IF THEY WANT A COPY AND ARE ENCOURAGED TO PERSONALLY VISIT WITH THE CFO TO COVER ANY TOPICS NECESSARY.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, ALL APPLICABLE PERSONNEL SIGN A CONFLICT OF INTEREST STATMENT AND, WHEN NEEDED, IT IS INCORPORATED INTO POLICIES.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD CHAIR AND EXECUTIVE COMMITTEE REVIEW THE COMPENSATION ANNUALLY AFTER RECEIPT OF THE AHA ANNUAL SALARY SURVEY.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. A NEW PATIENT HANDBOOK HAS BEEN DEVELOPED FOR ALL PATIENTS AND WILL BE HANDED OUT AT OUTPATIENT ADMISSIONS OR AVAILABLE FOR USE IN PATIENT ROOMS.
FORM 990, PART IX, LINE 11GPROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 5,106,913. MANAGEMENT AND GENERAL EXPENSES 762,427. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,869,340.
FORM 990, PART XI, LINE 9:DISTRIBUTION TO JOINT VENTURE PARTNER -298,455.
FORM 990, PART XII, LINE 2CTHE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL PAIN MANAGEMENT LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36EAddressLine1Txt
CityCYNTHIANACityNm
State AbbreviationKYStateAbbreviationCd
ZIP41031ZIPCd
FieldValueIRS element (for citing)
EIN472547452EIN
Primary ActivitiesPAIN MANAGEMENT SERVICESPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$353,517ShareOfTotalIncomeAmt
Share Of EOY Assets$313,815ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.51000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH PARTNERSHIP LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36EAddressLine1Txt
CityCYNTHIANACityNm
State AbbreviationKYStateAbbreviationCd
ZIP41031ZIPCd
FieldValueIRS element (for citing)
EIN611348611EIN
Primary ActivitiesHEALTH CARE PROMOTIONPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Share Of Total Income$114,954ShareOfTotalIncomeAmt
Share Of EOY Assets$3,960ShareOfEOYAssetsAmt
Ownership0.50000OwnershipPct
Controlled Organization0ControlledOrganizationInd
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 Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
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 Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd