KNOXVILLE COMMUNITY HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- KNOXVILLE COMMUNITY HOSPITAL INC (EIN 42-1087612)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-14
- IRS object ID
- 201821349349306042
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-14T14:09:35-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 476097913 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIM JOHNSON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421087612 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KNOXVILLE COMMUNITY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KNOX | BusinessNameControlTxt |
| Phone | 6418421407 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 SOUTH LINCOLN STREET | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50138 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MAGGIE HAMILTON-BEYER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6418421407 | PhoneNum |
| Signature | 2018-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARC D BEHRENS | PreparerPersonNm |
| PTIN | P01543366 | PTIN |
| Phone | 4023302660 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 209.34.201.180 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-05-11 | IPDt |
| IP Tm | 08:20:20 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 876BE3EDFAF35ED687A48C1D6A395F974978876D | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A4DB24C5AB8EB2ABEC143517BC341AFF020B8A0E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MAGGIE HAMILTON-BEYER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 SOUTH LINCOLN STREET | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50138 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,595,991 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KNOXVILLEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO FAITHFULLY PROVIDE EXCEPTIONAL HEALTHCARE TO THE PEOPLE OF KNOXVILLE & SURROUNDING COMMUNITIES AND TO BE A HEALTHCARE DESTINATION BUILT ON COMPASSION AND INNOVATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 368 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $1,120 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,796 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $247,468 | PYContributionsGrantsAmt |
| CY Contributions Grants | $142,636 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,209,209 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,217,081 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$5,647 | PYInvestmentIncomeAmt |
| CY Investment Income | $58,975 | CYInvestmentIncomeAmt |
| PY Other Revenue | $205,477 | PYOtherRevenueAmt |
| CY Other Revenue | $177,299 | CYOtherRevenueAmt |
| PY Total Revenue | $30,656,507 | PYTotalRevenueAmt |
| CY Total Revenue | $31,595,991 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $24,014 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,891 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,302,035 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,168,426 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,263,796 | PYOtherExpensesAmt |
| CY Other Expenses | $15,975,673 | CYOtherExpensesAmt |
| PY Total Expenses | $29,589,845 | PYTotalExpensesAmt |
| CY Total Expenses | $31,154,990 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,066,662 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $441,001 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $30,368,979 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,507,902 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,443,899 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,079,821 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,925,080 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,428,081 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE DEDICATED TO PROVIDING PERSONAL PROGRESSIVE QUALITY HEALTHCARE WITH COMPASSION TO THE PEOPLE OF KNOXVILLE AND SURROUNDING AREAS. WE VALUE TEAMWORK, INNOVATION, COMPASSION, INTEGRITY, SERVICE, AND PEOPLE-CENTERED CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $27,932,879 | ExpenseAmt |
| Grant | $10,891 | GrantAmt |
| Revenue | $31,230,415 | RevenueAmt |
| Desc | KNOXVILLE COMMUNITY HOSPITAL, INC. IS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE BEDS. THE HOSPITAL PROVIDES ACUTE AND ANCILLARY SERVICES TO INDIVIDUALS IN BOTH INPATIENT AND OUTPATIENT SETTINGS. DURING FISCAL YEAR 2017, THE HOSPITAL PROVIDED 1,058 DAYS OF SKILLED NURSING CARE AND 217,314 OUTPATIENT OCCASIONS OF SERVICE. | Desc |
| Total Program Service Expenses | $27,932,879 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 107 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 368 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MAGGIE HAMILTON-BEYER | PersonNm |
| Phone | 6418421402 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 SOUTH LINCOLN STREET | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50138 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MEGAN MCKAY | ||||||||
| PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM BUTLER | ||||||||
| 1ST VICE PRESIDENT | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PATRICK STOCKTON | ||||||||
| 2ND VP & TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TRESA MOTT | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LISA CROSSETT | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVE JOHNSON | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TODD CHAMBERS | ||||||||
| MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LORI BAILEY | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROCHELLE KLOOTWYK | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN KINCAID | ||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $257,895 | $0 | $16,284 | ||
| MAGGIE HAMILTON-BEYER | ||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $134,034 | $0 | $2,750 | ||
| DAVID KERMODE | ||||||||
| SURGEON | 40.00 | 0.00 | $403,677 | $0 | $22,135 | Yes (X) | ||
| MARTHA ERRTHUM | ||||||||
| PHYSICIAN | 39.00 | 1.00 | $239,810 | $0 | $29,989 | Yes (X) | ||
| THOMAS HOEHNS | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $260,206 | $0 | $21,674 | Yes (X) | ||
| EARL MCKEEVER | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $231,809 | $0 | $27,163 | Yes (X) | ||
| SHANNON REMMINGTON | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $242,259 | $0 | $36,760 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,769,690 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $156,755 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RUSSELL CONSTRUCTION COMPANY INC | |||||
| 4600 E 53RD STREET | DAVENPORT | IA | 52807 | GENERAL CONTRACTOR | $2,358,066 |
| DOCS EMERGENCY MEDICINE INC | |||||
| 800 W FRONTIER LN | OLATHE | KS | 66061 | ER PHYSICIAN COVEREAGE | $1,577,128 |
| 21ST CENTURY REHAB | |||||
| PO BOX 461 | NEVADA | IA | 50201 | PT/OT SERVICES | $851,581 |
| CERNER CORPORATION | |||||
| PO BOX 959156 | ST LOUIS | MO | 63195 | COMPUTER SOFTWARE SYSTEMS | $585,178 |
| SQUAREWAVEFORM ANESTHESIOLOGY | |||||
| PO BOX 1192 | MARSHALLTOWN | IA | 50158 | ANESTHESIOLOGY COVERAGE | $424,133 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $6,816 | RelatedOrganizationsAmt |
| Government Grants | $69,211 | GovernmentGrantsAmt |
| All Other Contributions | $66,609 | AllOtherContributionsAmt |
| Total Contributions | $142,636 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE | 621110 | $14,009,690 | $14,009,690 |
| NET PATIENT SERVICE REVENUE | 621110 | $11,479,663 | $11,479,663 |
| MEDICAID | 621110 | $3,178,927 | $3,178,927 |
| PHARMACY | 621110 | $2,445,993 | $2,445,993 |
| OTHER PROGRAM SERVICE REVENUE | 621110 | $74,763 | $74,763 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,045 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,045 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,217,081 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,685 | TotalRevenueColumnAmt |
| Exclusion | $55,685 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $38,193 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $38,193 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,193 | TotalRevenueColumnAmt |
| Exclusion | $38,193 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,290 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,290 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,290 | TotalRevenueColumnAmt |
| Exclusion | $3,290 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|---|
| CAFETERIA | 900099 | $125,772 | $1,120 | $124,652 | |
| MISCELLANEOUS | 900099 | $13,334 | $13,334 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $139,106 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,595,991 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,230,415 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,120 | UnrelatedBusinessRevenueAmt |
| Exclusion | $221,820 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,891 | TotalAmt |
| Program Services | $10,891 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $410,962 | TotalAmt |
| Management And General | $410,962 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,046,909 | TotalAmt |
| Program Services | $10,698,903 | ProgramServicesAmt |
| Management And General | $1,348,006 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,710,555 | TotalAmt |
| Program Services | $2,347,776 | ProgramServicesAmt |
| Management And General | $362,779 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,935 | TotalAmt |
| Program Services | $75,836 | ProgramServicesAmt |
| Management And General | $142,099 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,370 | TotalAmt |
| Management And General | $21,370 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,798 | TotalAmt |
| Management And General | $79,798 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,571 | TotalAmt |
| Management And General | $4,571 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,987,993 | TotalAmt |
| Program Services | $4,834,557 | ProgramServicesAmt |
| Management And General | $153,436 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,430 | TotalAmt |
| Program Services | $146,430 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $567,888 | TotalAmt |
| Program Services | $430,862 | ProgramServicesAmt |
| Management And General | $137,026 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,260 | TotalAmt |
| Program Services | $62,163 | ProgramServicesAmt |
| Management And General | $97 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,852,880 | TotalAmt |
| Program Services | $1,776,629 | ProgramServicesAmt |
| Management And General | $76,251 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,059 | TotalAmt |
| Program Services | $19,649 | ProgramServicesAmt |
| Management And General | $25,410 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,584 | TotalAmt |
| Program Services | $26,584 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,743 | TotalAmt |
| Program Services | $556,866 | ProgramServicesAmt |
| Management And General | $75,877 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,008,469 | TotalAmt |
| Program Services | $1,767,618 | ProgramServicesAmt |
| Management And General | $240,851 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,245 | TotalAmt |
| Program Services | $200,957 | ProgramServicesAmt |
| Management And General | $45,288 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,945,040 | $3,945,040 | |
| BAD DEBTS | $787,136 | $787,136 | |
| DUES & LICENSES | $214,288 | $124,844 | $89,444 |
| FOOD COST | $107,791 | $107,791 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,193 | TotalAmt |
| Program Services | $12,347 | ProgramServicesAmt |
| Management And General | $8,846 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,154,990 | TotalAmt |
| Program Services | $27,932,879 | ProgramServicesAmt |
| Management And General | $3,222,111 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,800 | BOYAmt |
| EOY | $48,313 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,715,610 | BOYAmt |
| EOY | $7,091,949 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,049,146 | BOYAmt |
| EOY | $3,333,818 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,701 | BOYAmt |
| EOY | $28,701 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $320,605 | BOYAmt |
| EOY | $25,600 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,203 | BOYAmt |
| EOY | $394,945 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,462 | BOYAmt |
| EOY | $320,085 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,279,443 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,295,169 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,817,836 | BOYAmt |
| EOY | $17,984,274 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,180,057 | BOYAmt |
| EOY | $2,208,004 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,275 | BOYAmt |
| EOY | $67,213 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $465,284 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,368,979 | BOYAmt |
| EOY | $31,507,902 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,221,682 | BOYAmt |
| EOY | $1,713,690 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,821,979 | BOYAmt |
| EOY | $15,456,417 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,290,388 | BOYAmt |
| EOY | $1,086,084 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,850 | BOYAmt |
| EOY | $1,823,630 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,443,899 | BOYAmt |
| EOY | $20,079,821 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,925,080 | BOYAmt |
| EOY | $11,428,081 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,925,080 | BOYAmt |
| EOY | $11,428,081 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,368,979 | BOYAmt |
| EOY | $31,507,902 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $441,001 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $62,000 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,783 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,783 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | KNOXVILLE COMMUNITY HOSPITAL, INC. PAYS DUES TO THE IOWA HOSPITAL ASSOCIATION, OF WHICH A PORTION (21%) IS USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $252,056 | OtherCostOrOtherBasisAmt |
| Book Value | $252,056 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,835,167 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,491,629 | DepreciationAmt |
| Book Value | $13,343,538 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,170,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,803,540 | DepreciationAmt |
| Book Value | $4,366,514 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,166 | OtherCostOrOtherBasisAmt |
| Book Value | $22,166 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,984,274 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASES | $1,811,877 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $11,753 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,823,630 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL HAS RECEIVED A DETERMINATION LETTER INDICATING THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN THE HOSPITAL'S TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE HOSPITAL TO MEET A COMMUNITY BENEFITS STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2017 AND 2016, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $98,829 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $98,829 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,198,017 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,178,927 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,019,090 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03360 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,949,718 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,133,298 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,816,420 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,246,564 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,312,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,934,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09670 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,454 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,138 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $228,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $228,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,933 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,185 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $297,337 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $286,014 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,543,901 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,323,548 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,220,353 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10600 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,820 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,820 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,513 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,513 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,362 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $559 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,881 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,423 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,423 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,839 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,839 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $39,397 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $559 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,838 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $787,136 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,477,662 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,564,856 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$87,194 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KNOXVILLE COMMUNITY HOSP INC & CLINICS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 S LINCOLN STREET | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50138 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.KNOXVILLEHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 630031H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KNOXVILLE COMMUNITY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.KNOXVILLEHOSPITAL.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.KNOXVILLEHOSPITAL.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.KNOXVILLEHOSPITAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.KNOXVILLEHOSPITAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| KNOXVILLE COMMUNITY HOSPITAL, INC. | PART V, SECTION B, LINE 3J: THE TOP FOUR HEALTH NEEDS IDENTIFIED FROM THE 2015 CHNA REPORT WERE MENTAL HEALTH, WELLNESS, HEALTHY EATING CHOICES AND PREVENTATIVE MEDICINE. OTHER HEALTH NEEDS IDENTIFIED WERE HEALTH ACCESS, TRANSPORTATION, BEDS, EDUCATION, WELLNESS EDUCATION, SUBSTANCE ABUSE TREATMENT AND PREVENTION, FAMILY PLANNING IN HIGH SCHOOL FOR BIRTH CONTROL, TRAILS AND SIDEWALKS, SPECIALTY SERVICES LIKE PSYCHIATRY, ORTHOPEDICS, G.I., OBGYN, COMMUNITY PERCEPTION AND COMMUNICATION, COMMUNITY BUY-IN FOR PREVENTIVE HEALTHCARE, CANCER, ADULT DAY CARE, UNINSURED DENTAL CARE, URGENT CARE, ECONOMIC DEVELOPMENT, EXTENDED CLINIC HOURS, WEEKEND HOSPITAL SERVICE, OCCUPATIONAL HEALTH PROVIDERS, BETTER COORDINATION AMONG PROVIDERS, MAMMOGRAPHY, ER DOCTORS, EXPAND MEDICAID, VETERANS CARE, DIABETES EDUCATION AND MONITORING, MENTAL HEALTH TELEMEDICINE SERVICES AVAILABLE AND HEALTHY WEIGHT PLANNING. |
| KNOXVILLE COMMUNITY HOSPITAL, INC. | PART V, SECTION B, LINE 5: RESEARCH WAS PERFORMED AND DATA WAS COLLECTED TO ENSURE PROPER TOWN HALL REPRESENTATION AND TO DETERMINE THE PRIMARY SERVICE AREA. PR STORY WAS PREPARED AND SENT TO LOCAL MEDIA TO PUBLISH AND ANNOUNCE UPCOMING CHNA WORK AND REQUEST PUBLIC SURVEY PARTICIPATION. A PAPER SURVEY WAS USED WITH AN ONLINE LINK TO PSA RESIDENTS. THE SURVEY WAS SENT TO 1,000 PARTICIPANTS WITH ANTICIPATION OF RECEIVING 250 RETURNS. WE PREPARED AND PUBLISHED A TOWN HALL INVITATION TO THE PUBLIC AND COLLABORATING PARTIES SUCH AS PUBLIC HEALTH, SCHOOL LEADERS, FAITH-BASED LEADERS, PHYSICIANS AND OTHER CARE PROVIDERS, MENTAL HEALTH COMMUNITY, FREE CLINICS, LOCAL RESIDENTS, COMMUNITY LEADERS, BUSINESS LEADERS, LOCAL GOVERNMENT, PEOPLE WITH CHRONIC CONDITIONS, UNINSURED COMMUNITY MEMBERS, LOW INCOME RESIDENTS, AND MINORITY GROUPS ALONG WITH KNOXVILLE HOSPITAL AND CLINICS. WE PREPARED A BRIEF OF GOALS, OBJECTIVES, PURPOSE, OUTCOME, ROLES, AND COMMUNITY INVOLVEMENT AND HELD A KICK-OFF MEETING. COMMUNITY HEALTH FACTS AND PRACTICE DATA WERE COLLECTED AND PUBLISHED. A SECOND ROUND TABLE WAS THEN HELD TO REVIEW THE RESEARCH GATHERED, OPINIONS GIVEN, AND NEEDS IDENTIFIED. COMMUNITY OPINIONS WERE COLLECTED ON HEALTH NEEDS, PRACTICES, AND PHYSICIAN AND CARE PROVIDER MANPOWER AVAILABILITY. THE COMMUNITY HEALTH NEEDS REPORT WAS THEN PREPARED AND PRESENTED TO COMMUNITY LEADERS WITH RECOMMENDED ACTIONS. AT THE TOWN HALL MEETING THE DISCUSSION INCLUDED PURPOSE, ROLES, REVIEW OF HISTORICAL DATA, PARTICIPANT DISCUSSIONS TALLY AND RANKING OF HEALTH CONCERNS, AND REFLECTION ON THE HEALTH NEEDS OF THE COMMUNITY. THE MEETING CLOSED WITH INFORMATION ABOUT THE NEXT STEPS. THE COMMUNITY WAS ENCOURAGED TO CONTINUE TO PARTICIPATE BY CONTRIBUTING IDEAS TO THE HOSPITAL AND HEALTH DEPARTMENT VIA EMAIL OR PERSONAL CONVERSATIONS. IN ADDITION, OTHER MEETINGS, INTERVIEWS, AND FOCUS GROUPS WERE HELD. |
| KNOXVILLE COMMUNITY HOSPITAL, INC. | PART V, SECTION B, LINE 11: DURING THE FISCAL YEAR JULY 1, 2016 THRU JUNE 30, 2017 THE HOSPITAL ADDRESSED THE SIGNIFICANT NEEDS IN THE FOLLOWING WAYS:1.) INPATIENT MENTAL HEALTH SERVICES- KEVIN KINCAID, CEO OF THE HOSPITAL SPENT APPROXIMATELY 80 HOURS ON ACTIVITIES SPECIFIC TO MENTAL HEALTH REDESIGN AND IMPROVEMENTS. MOST OF THE EFFORTS WERE CONCENTRATED ON STATEWIDE AND COUNTYWIDE INITIATIVES. THROUGH THE IOWA HOSPITAL ASSOCIATION THERE WERE SEVERAL INTERACTIONS WITH INDIVIDUAL LEGISLATORS AND SUBCOMMITTEE HEARINGS ON MENTAL HEALTH. IN COLLABORATIONS WITH THE MARION COUNTY SHERIFF'S OFFICE, WE ORGANIZED A REGIONAL LISTENING POST FOR PUBLIC COMMENT ON OPIOID ADDICTION AND THE CONNECTION TO MENTAL HEALTH. KEVIN ALSO ATTENDED SEVERAL OF OUR MENTAL HEALTH REGIONAL MEETINGS FOR INPUT.2.) ACCESS TO MENTAL HEALTH PROVIDERS- IN FEBRUARY OF 2017 THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT IMPLEMENTED TELE-PSYCH TO IMPROVE ACCESS TO MENTAL HEALTH PROVIDERS IN THE EMERGENCY DEPARTMENT. THE TELE-PSYCH SYSTEM IS UTILIZED FOR AROUND 95% OF OUT MENTAL HEALTH PATIENTS THAT PRESENT IN THE ED. THE PROGRAM ASSISTED WITH TRANSFERRING MOST OF THOSE PATIENT TO A MENTAL HEALTH FACILITY. SOME PATIENTS COULD RETURN TO THE HOME WITH OUTPATIENT THERAPY PER THE RECOMMENDATIONS OF THE ITP OUR TELE-PSYCH PROVIDER.THE USE OF TELE-PSYCH FREES UP VALUABLE TIME FOR THE NURSES AS ITP WILL DO ALL OF THE LEG WORK IN FINDING PLACEMENT FOR OUR PATIENTS WHEN THEY REQUIRE TRANSFER TO AN INPATIENT FACILITY. THIS SERVICE DOES FACILITATE GETTING PATIENTS TO A HIGHER LEVEL OF CARE AS WE ARE AT THE MERCY OF A SMALL NUMBER OF MENTAL HEALTH HOSPITAL BED THROUGHOUT THE STATE.TELE-PSYCH DOES HELP TREMENDOUSLY IN THE CARE OF THE PATIENT. IT ALLOWS OUR PROVIDERS TO UTILIZE MENTAL HEALTH PROFESSIONALS FOR AN EXPERT OPINION ON THE SPECIAL TREATMENT NEEDS FOR THESE PATIENTS. ITPS PROVIDERS CAN ALSO BE A GREAT RESOURCE FOR ASSISTING ED PROVIDERS WITH MEDICATION ADJUSTMENT CONSULTS.3.) FIGHT OBESITY (NUTRITION AND FITNESS)- EFFECTIVE MEDIA FOR EDUCATION THE KNOXVILLE COMMUNITY HAS BEEN IMPLEMENTED BY HOSPITAL'S MARKETING TEAM AND VARIOUS HEALTH AND WELLNESS LEADERS. DIETARY AND PHYSICAL ACTIVITY TIPS ARE PROVIDED ON THE HOSPITAL'S FACEBOOK PAGE ON A WEEKLY BASIS. ACCREDITED ARTICLES, TIPS FROM THE HOSPITAL'S DIETITIAN AND PHYSICAL THERAPY TEAM ARE PROVIDED FOR THE HOSPITAL'S FACEBOOK FOLLOWERS. A RADIO SPOTLIGHT HAS BEEN COMPLETED BY THE HOSPITAL DIETITIAN ON WAYS TO FIGHT OBESITY, AS WELL AS DIABETES MANAGEMENT AND PREVENTING CHRONIC DISEASES IN JANUARY OF 2018. THE HOSPITAL WILL CONTINUE REACHING OUT TO THE COMMUNITY THROUGH MEDIA ON A CONSISTENT BASIS.THE HOSPITAL IS WORKING UNDER THE STATE INNOVATION MODEL IN COLLABORATION OF MARION COUNTY PUBLIC HEALTH WITH MAJOR IMPROVEMENTS MADE TOWARDS OUR MAIN FOCAL POINT, THE SIMS PROJECT. AS OF DECEMBER 2017, OUR SIMS PROGRAM HAS GROWN AT A PROGRESSIVE RATE WITH IMPLAUSIBLE AND POSITIVE RESULTS. ON AVERAGE, 80% OUR DIABETIC PATIENTS THAT ARE LOYAL TO OUR SIMS PROGRAM HAVE IMPROVED THEIR A1C% RESULTS. THERE IS NOW A FULL-TIME NURSE DEDICATED SOLELY TO SIMS PARTICIPANTS, DUE TO ENCOURAGING OUTCOMES FOR REFERRED DIABETIC PATIENTS AND AN IMPROVED COMMUNICATION SYSTEM WITH PROVIDERS. THE PROGRAM WILL BE CONTINUED WITH NO ANTICIPATED CONCLUDING DATE. THE HOSPITAL CONTINUES TO EXPLORE WEIGHT LOSS PROGRAM OPTIONS DESIGNED TO FIT THE NEEDS OF THE COMMUNITY. THE HOSPITAL'S REGISTERED DIETITIAN HAS MADE IT A PRIORITY AND GOAL TO HAVE A TENTATIVE PROGRAM OUTLINED BY THE END OF 2019.THE HOSPITAL WILL CONTINUE TO HOST NUTRITION FOCUSED COOKING CLASSES AT LEAST TWICE A YEAR TO THE COMMUNITY. A PARTNERSHIP WITH THE LOCAL HY-VEE HAS BEEN CREATED AND WILL BE BUILT UPON, WITH DISCUSSION OF FREEZER MEAL CLASSES FOR GENERAL HEALTH AND DIABETES. THE HOSPITAL'S DIETITIAN AND NUTRITION SERVICES TEAM IS ARRANGING TO HOST COOKING CLASSES FOR HOSPITAL STAFF LX/MONTH STARTING IN THE FALL OF 2018. THE HOSPITAL'S DIETITIAN IS ALSO PLANNING TO COLLABORATE WITH THE KNOXVILLE COMMUNITY SCHOOL DISTRICT TO IMPLEMENT COOKING CLASSES FOR STUDENTS AND PARENTS, FOCUSING PRIMARILY ON ATHLETES AND PROPER NUTRITION.4.) VISITING SPECIALISTS CLINICS (PEDIATRICS AND PULMONOLOGY)- THE HOSPITAL'S ADMINISTRATION CONTINUES TO WORK CLOSELY WITH THEIR NETWORK PARTNER, MERCY HEALTH NETWORK TO INCREASE LOCAL ACCESS TO VARIOUS MEDICAL SPECIALISTS. IN THE FALL OF 2017, THE HOSPITAL ENTERED INTO A CONTRACT TO PROVIDE A MERCY ENT SPECIALIST AT THE HOSPITAL. DR. DEAN A BOARD-CERTIFIED ENT SPECIALIST HOLDS A MONTHLY CLINIC SERVING THE KNOXVILLE COMMUNITY. DR. DEAN IS SEEING AROUND 12 TO 14 PATIENTS EACH MONTH AND MOST WHO ARE UNDER THE AGE OF 18.DEVELOP A MARKETING PLAN TO PROMOTE TO THE COMMUNITY THE HOSPITAL'S PROVIDERS WHO HAVE EXTENSIVE EXPERIENCE CARING FOR PEDIATRIC PATIENTS. SOME OF THE MARKETING STRATEGIES INCLUDED:A.) PARTICIPATE IN COMMUNITY SPONSORED EVENTS INVOLVING CHILDREN AND FAMILIESB.) ORGANIZE AND SPONSOR A KIDS' HEALTH FAIR, IN PARTNERSHIP WITH ISU EXTENSION SERVICE AND OTHER LOCAL GROUPS AND BUSINESSESC.) PARTNER WITH AREA SCHOOL SYSTEMS TO PROVIDE PUBLIC HEALTH INFORMATION TO STUDENTSD.) HOST A "TOUR THE HOSPITAL" EVENT FOR ALL NEW SCHOOL EMPLOYEESE.) SPONSOR HEALTH EDUCATION BOOKS FOR ALL 1ST GRADE STUDENTSF.) PARTNER WITH KNOXVILLE SCHOOL SYSTEM AND CITY OF KNOXVILLE ON A HEALTHY KIDS INITIATIVE WALKG.) DONATE HEALTHY SNACKS FOR THE MISS MARY STRAWBERRY CLASSES ON A QUARTERLY BASISH.) USE FACEBOOK MONTHLY TO DISTRIBUTE HEALTH INFORMATION TO PARENTS AND YOUTH, WHICH CAN BE SHARED BY THE SCHOOLS ON THEIR FACEBOOK SITESI.) PARTICIPATE IN THE BACKPACK BUDDIES PROGRAM, WHICH PROVIDES HEALTHY SNACKS AND MEALS TO LOW-INCOME CHILDRENJ.) HOST A SCHOOL SUPPLIES DRIVEK.) DEVELOP AND DISTRIBUTE CHILDHOOD IMMUNIZATION GUIDEL.) DEVELOP AND DISTRIBUTE A BROCHURE LISTING ALL PRIMARY CARE PROVIDERS. THE BROCHURE WILL BE DISTRIBUTED TO ALL ACUTE CARE PATIENTS, ALL NEW PATIENTS, TO ALL NEW COMMUNITY RESIDENTS, AND MADE AVAILABLE AT PUBLIC EVENTS.M.) PARTICIPATE IN THE WARM WELCOMES PROGRAM, WHICH GREETS ALL NEW RESIDENTS IN THE COMMUNITYN.) PARTNER WITH MARION COUNTY PUBLIC HEALTH DEPARTMENT ON SEVERAL COMMUNITY OUTREACH PROGRAMS SERVING YOUTH AND THEIR FAMILIESO.) PARTICIPATE ON COMMITTEES SERVING YOUTH (WELLNESS COMMITTEE, THRIVE, MENTAL HEALTH COALITION, ETC.)P.) ESTABLISH RELATIONSHIPS AND LIAISON WITH LOCAL BUSINESSES, COMMUNITY ORGANIZATIONS, GOVERNMENTAL ENTITIES, PUBLIC HEALTH ORGANIZATION, YOUTH GROUPS.5.) HEALTHCARE TRANSPORTATION- INVESTIGATE TRANSPORTATION SOLUTIONS IN OTHER (SIMILAR) HOSPITALS. IDENTIFY POSSIBLE SOLUTIONS TO ELIMINATE BARRIERS OF CURRENT TRANSPORTATION OPTIONS. COLLABORATE WITH MARION COUNTY PUBLIC HEALTH, MARION COUNTY BOARD OF SUPERVISORS, LOCAL RESOURCE ORGANIZATIONS, OTHER HOSPITALS AND THE HOSPITAL'S LEADERS AND STAFF. PLAN TACTICS UTILIZED TO ADDRESS THESE NEEDS INCLUDED THE FOLLOWING:A.) ONE OF THE HOSPITAL'S EMPLOYEES (GINNY KRICHAU) JOINED HIRTA TAG COMMITTEE- GROUP THAT MEETS QUARTERLY TO DISCUSS TRANSPORTATION NEEDS/ISSUES AND BRAINSTORMS SOLUTIONS. THIS GROUP ALSO HOSTS ANNUAL STRATEGIC PLANNING MEETINGS INCLUDING THE LOCAL COMMUNITY, INCLUDING STAFF FROM VARIOUS COMMUNITY RESOURCES AND ALSO PEOPLE WHO UTILIZE/NEED TRANSPORTATION SERVICES.B.) HIRTA AND THE HOSPITAL ARE TRIALING A NEW PROCESS FOR PATIENTS WHO NEED A RIDE HOME AFTER AN APPOINTMENT. HIRTA PROVIDED THE HOSPITAL WITH A PRIVATE "WILL CALL" NUMBER IN HOPES TO EXPEDITE THE DRIVER RETURN TIME. PRIOR TO THIS, CALLERS HAD TO REMAIN ON HOLD FOR LONG PERIODS OF TIME, WAITING IN THE CUE FOR DISPATCH. MEANWHILE, THE PATIENT WAITED (SOMETIMES MORE THAN 40 MINUTES) FOR A RIDE HOME.C.) THE HOSPITAL RECEIVED A GRANT FROM COVERYS FOR A PATIENT'S "SAFE TRANSITIONS". PART OF THE FUNDING FROM THIS GRANT WILL ASSIST PATIENTS WITH A SAFE RIDE HOME FROM THE HOSPITAL.D.) THE HOSPITAL BEGAN A COMMUNITY PATIENT/FAMILY ADVISORY COUNCIL CONSISTING OF PATIENTS/FAMILIES, STAFF AND VOLUNTEERS. THE GROUP MEETS 6-7 TIMES PER YEAR TO DISCUSS VARIOUS ISSUES/OPTIONS CONCERNING ALL ASPECTS OF HEALTHCARE AND INTERACTIONS WITH THE HOSPITAL (INCLUDING ACCESS TO SERVICES-TRANSPORTATION).E.) THE HOSPITAL, MARION COUNTY PUBLIC HEALTH AND PELLA REGIONAL HEALTH CENTER WORK COLLABORATIVELY AS PART OF THE SIM GRANT- TRANSPORTATION AND ACCESS TO SERVICES ARE COMMON TOPICS AS ARE OTHER SOCIAL DETERMINANTS OF HEALTH.F.) SEVERAL OF THE HOSPITAL'S STAFF MEMBERS REGULARLY ATTEND VARIOUS MEETINGS IN WHICH COMMUNITY MEMBERS COLLABORATE/WORK TO PREVENT VARIOUS LIFE/HEALTH ISSUES. TRANSPORTATION AND ACCESS TO SERVICES/SOLUTIONS ARE OFTEN THE TOPIC. THE FOLLOWING ARE SOME OF THE GROUP MEETINGS ATTENDED:I.) MARION COUNTY COALITION FOR CHANGE (MC3) -SUBSTANCE ABUSE TASK FORCEII.) SUICIDE PREVENTION TASK FORCEIII.) KNOXVILLE COMMUNITY WELLNESS- WORKING WITH WELLMARK'S "HEALTHIEST HOMETOWNS" INITIATIVEIV.) MARION COUNTY BEHAVIORAL HEALTH TASK FORCE |
| KNOXVILLE COMMUNITY HOSPITAL, INC. | PART V, SECTION B, LINE 13H: THE HOSPITAL CONSIDERED FAMILY SIZE IN ADDITION TO THE CRITERIA ABOVE. |
| KNOXVILLE COMMUNITY HOSPITAL, INC. | PART V, SECTION B, LINE 15E: A LETTER IS SENT PRIOR TO COLLECTION DETAILING THE PAYMENT PLAINS AND FINANCIAL ASSISTANCE AVAILABLE TO THOSE WHO QUALIFY. |
| KNOXVILLE COMMUNITY HOSPITAL, INC. | PART V, SECTION B, LINE 16J: A LETTER IS SENT, AND IN MANY CASES TWO, PRIOR TO COLLECTION DETAILING THE PAYMENT PLANS AND FINANCIAL ASSISTANCE AVAILABLE TO THOSE WHO QUALIFY. THE HOSPITAL ALSO MAKES THREE ATTEMPTS TO REACH BY PHONE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - KNOXVILLE AREA COMMUNITY HOSPITAL CLINIC | ||||
| 1202 WEST HOWARD STREET | KNOXVILLE | IA | 50138 | PHYSICIAN CLINIC |
| 2 - MELCHER PHYSICIANS CLINIC | ||||
| 113 NORTH MAIN STREET | MELCHER | IA | 50163 | PHYSICIAN CLINIC |
| 3 - PLEASANTVILLE PHYSICIAN CLINIC | ||||
| 104 NORTH WASHINGTON STREET | PLEASANTVILLE | IA | 50225 | PHYSICIAN CLINIC |
| 4 - RED ROCK HEALTH CENTER | ||||
| 615 WASHINGTON STREET | PELLA | IA | 50219 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE OR DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. |
| PART I, LINE 7: | THE COST TO CHARGE RATIO AS FOLLOWS WAS USED TO DETERMINE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS AT COST: (TOTAL EXPENSES - BAD DEBT) / (GROSS PATIENT SERVICE REVENUE + OTHER REVENUE) = PERCENTAGE OF COST TO CHARGE. OTHER COMMUNITY BENEFIT EXPENSES ARE STATED AT COST BASED ON KNOXVILLE COMMUNITY HOSPITAL INC.'S INTERNAL ACCOUNTING RECORDS. |
| PART I, LINE 7G: | THERE ARE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G. |
| PART I, LN 7 COL(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 $787,136. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY SERVICE: THE HOSPITAL PROVIDES MEETING ROOM SPACE TO A LARGE NUMBER OF COMMUNITY ORGANIZATIONS AT NO COST. THE HOSPITAL PROVIDES SUPPORT TO THE LOCAL CHAMBER WITH MONETARY AND TIME DONATIONS. A FIRST AID TENT INCLUDING LABOR AND SUPPLIES FOR MEDICAL TREATMENT IS PROVIDED DURING KNOXVILLE NATIONALS AND CHAMBER EVENTS. THE HOSPITAL HOSTS AN ANGEL TREE EVERY YEAR TO HELP FAMILIES IN NEED AT CHRISTMAS. EMPLOYEES PARTICIPATE IN FESTIVAL OF TREES AND HELP AT FOOD PANTRY. THE HOSPITAL OFFERS HEALTH FAIRS ANNUALLY TO MEN, WOMEN AND CHILDREN.ECONOMIC DEVELOPMENT: HOSPITAL LEADERS ARE SENT TO LEADERSHIP DEVELOPMENT TRAINING ANNUALLY. ROTATIONS AND PRECEPTORSHIPS ARE MADE AVAILABLE IN VARIOUS SPECIALTIES FOR STUDENTS GOING INTO THE MEDICAL FIELD. JOB SHADOWING IS PROVIDED FOR LOCAL HIGH SCHOOL AND COLLEGE STUDENTS. THE HOSPITAL IS A MEMBER OF THE LOCAL CHAMBER AND ROTARY CLUB, WITH EMPLOYEES PARTICIPATING IN BOTH. THE HOSPITAL'S COMPLIANCE OFFICER IS ON THE LOCAL DAY CARE BOARD. THE HOSPITAL DONATES TO LOCAL PROJECTS ON A REGULAR BASIS.COMMUNITY SUPPORT: MONETARY AND IN-KIND DONATIONS ARE GIVEN TO MANY COMMUNITY ORGANIZATIONS AND SCHOOL GROUPS IN SUPPORT OF CANCER FUND RAISERS, PROM SAFETY EVENTS, SPORTING TEAMS, AND OTHER EVENTS. THE HOSPITAL PARTICIPATES IN LOCAL PARADES AND CHAMBER EVENTS. HOSPITAL EMPLOYEES SERVE ON LOCAL COMMUNITY BOARDS; SPEAK AT SCHOOL HEALTH AND CAREER EVENTS; PARTICIPATE IN THE LOCAL THEATER GROUP; PROVIDE COACHING FOR AREA SPORTS TEAMS; AND DONATE TIME TO HABITAT FOR HUMANITY; AND 4H CLUBS.ECONOMIC IMPROVEMENTS: THE HOSPITAL AGGRESSIVELY RECRUITS FOR NEW PROVIDERS IN AN EFFORT TO SUSTAIN AND GROW. THE HOSPITAL COMPLETED AN EXTENSIVE REMODEL AND EXPANSION, UTILIZING AREA VENDORS. THE HOSPITAL CONTINUOUSLY LOOKS FOR NEW WAYS TO IMPROVE THE HEALTH OFFERINGS PROVIDED TO THE COMMUNITY. THE HOSPITAL STARTED THE "LET'S DO MORE" CAMPAIGN TO CONTINUE FACILITY IMPROVEMENTS. THE HOSPITAL HAS FORMED A RELATIONSHIP WITH AREA SCHOOLS, OFFERING FREE SPORTS PHYSICALS. COALITION BUILDING: THE HOSPITAL'S ER COORDINATOR IS A MEMBER OF THE MARION COUNTY HEALTH COALITION TEAM, WHICH INCLUDES A NUMBER OF NURSES ALSO EMPLOYED BY THE HOSPITAL. THE ER NURSE COORDINATOR IS A MEMBER OF THE IOWA NURSE COALITION, EBOLA, PHEL, CEPC, AND STAR. HOSPITAL EMPLOYEES WORK WITH THE LOCAL PUBLIC HEALTH DEPARTMENT. THE HOSPITAL ALSO PERFORMS THE COMMUNITY HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENT AND MAINTAINS A PRESENCE IN THE COMMUNITY MENTAL HEALTH TEAM.COMMUNITY HEALTH IMPROVEMENT: THE HOSPITAL PROVIDES FOOD TO THE LOCAL FOOD PANTRY WEEKLY AND PARTICIPATES IN MEALS ON WHEELS THROUGHOUT THE YEAR. THE HOSPITAL HOSTS, PARTICIPATES IN, OR PROVIDES SUPPORT FOR A VARIETY OF COMMUNITY PROGRAMS AND EVENTS INCLUDING PICK A BETTER SNACK SCHOOL PROGRAM, LOCAL HEALTH FAIRS, GIRLS NIGHT OUT, LOVE YOUR HEART DAY, SPORTS PHYSICALS, SPORTING EVENTS, DIABETES EDUCATION, CPR AND BLS CLASSES, FLU SHOT CLINICS, HEALTHY COOKING CLASSES, AND MORE. DOCTORS, NURSES AND CLERKS WORK AT THE LOCAL FREE CLINIC AT NO CHARGE. PHYSICIANS PARTICIPATE IN LOCAL HEALTH BOARDS AND CONSULT FREE OF CHARGE TO THE OTHER ORGANIZATIONS. THE HOSPITAL HAS EXTENDED ITS HOURS TO IMPROVE ACCESS TO CARE AT A LOWER COST. THE HOSPITAL CEO IS NOW ON OTHER ORGANIZATIONS' BOARDS, AND CONTINUES TO WORK ON A PLAN TO IMPROVE ACCESS TO MENTAL HEALTH CARE TO PATIENTS IN OUR AREA. THE HOSPITAL IS INVOLVED IN AN ACO HEALTH GRANT, FOR WHICH A NURSE PROVIDES HEALTH EDUCATION AND CARE FOR PATIENTS WITH VARIOUS HEALTH NEEDS.OTHER: THE HOSPITAL PROVIDES CAB FARE FROM THE EMERGENCY ROOM FOR INDIGENTS AND USE OF OUR ROOMS FOR LOCAL CLUBS AND COMMUNITY MEETINGS. ADMINISTRATIVE ASSISTANCE IS OFFERED TO VARIOUS ORGANIZATIONS. ONE OF OUR DOCTORS IS PRESIDENT OF THE IOWA PHYSICIANS SOCIETY AND PHYSICIAN CHAMPION FOR THE ACO HEALTH GRANT. THE HOSPITAL NOW OFFERS TELEHEALTH TO HELP PROVIDE ACCESS TO MENTAL HEALTH PROFESSIONALS TO OUR AREA PATIENTS. CURRENTLY, THE HOSPITAL HAS A LOCAL PROVIDER OFFERING SERVICES ON A LIMITED BASIS. |
| PART III, LINE 4: | THE HOSPITAL'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 7 AND 9 OF THE ATTACHED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES, NET," "NET PATIENT SERVICE REVENUE AND "CHARITY CARE". |
| PART III, LINE 8: | "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT D & E WORKSHEETS, OR PS&R. |
| PART III, LINE 9B: | THE CHARITY CARE POLICY ALLOWS FOR PROACTIVE WRITE OFF TO ALLOWANCE FOR CHARITY CARE OF ANY BALANCE OWED BY A PATIENT KNOWN TO QUALIFY FOR CHARITY CARE UNDER THE FINANCIAL ASSISTANCE POLICY. COLLECTION PROCEDURES DO NOT ENSUE ON ANY ACCOUNTS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 2: | DURING FISCAL YEAR 2016, KNOXVILLE COMMUNITY HOSPITAL, INC. AND CLINICS, IN COLLABORATION WITH MARION COUNTY PUBLIC HEALTH, HELD TOWN HALL MEETINGS TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT TO SET HEALTH GOALS AND PROGRAMS TO ADDRESS THE HEALTH NEEDS AND DESIRES OF THE COMMUNITY CAPTURED IN THE HOSPITAL'S ANNUAL COMMUNITY BENEFIT REPORT. ALSO, THE HOSPITAL ALWAYS UTILIZES INPUT FROM MEDICAL STAFF, THE BOARD OF DIRECTORS AND VARIOUS HOSPITAL ADMINISTRATIVE STAFF WHO REGULARLY REVIEW THE TREATMENT OF PATIENTS TO ENSURE MEDICAL NECESSITY AND APPROPRIATE LEVELS OF CARE ARE CONSISTENTLY PROVIDED TO THE PATIENTS OF THE HOSPITAL. |
| PART VI, LINE 3: | CUSTOMER SERVICE AND BILLING STAFF CONTINUALLY MONITOR BALANCES WITHOUT ACTIVITY AND THEN CONTACT THE PATIENTS TO OFFER FINANCIAL ASSISTANCE OR ARRANGE PAYMENT PLANS. THE HOSPITAL ALSO OFFERS THE ABILITY TO MAKE PAYMENTS VIA A WEB-BASED PORTAL. THE PORTAL CONTAINS INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE AND PAYMENT PLAN POLICIES. |
| PART VI, LINE 4: | THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING CITIES IN MARION COUNTY: KNOXVILLE (POP. 11,583), PLEASANTVILLE (POP. 2,954), AND MELCHER/DALLAS (POP. 1,625). THE KNOXVILLE COMMUNITY IS 40 MILES SOUTHEAST OF DES MOINES, IOWA. |
| PART VI, LINE 5: | KNOXVILLE COMMUNITY HOSPITAL, INC. AND THE CLINICS PROVIDE NUMEROUS OUTPATIENT SPECIALTY PROVIDER CLINICS SUCH AS PODIATRY, ORTHOPEDICS, CARDIOLOGY, UROLOGY, DERMATOLOGY, SLEEP STUDY, ONCOLOGY, AUDIOLOGY, RHEUMATOLOGY AND EMG TESTING AND OBGYN. PROVIDERS AND STAFF PROVIDE VARIOUS FREE EDUCATIONAL/WELLNESS PROGRAMS FOR THE COMMUNITY/SCHOOLS. THE HOSPITAL IS ADDING TO ITS SPECIALTIES YEARLY, HOSTING ANNUAL PUBLIC EVENTS INCLUDING SAFE SITTER CLASSES AND FREE SKIN CANCER SCREENING. THESE ARE PUBLISHED IN LOCAL NEWSPAPERS. |
| PART VI, LINE 6: | DURING FISCAL YEAR 2016, KNOXVILLE COMMUNITY HOSPITAL, INC. AND CLINICS WERE AFFILIATED MEMBERS OF THE MERCY HEALTH NETWORK - CENTRAL IOWA THROUGH MERCY HOSPITAL - DES MOINES, IOWA. MERCY HEALTH NETWORK - CENTRAL IOWA INCLUDES 16 CAH/TWEENER HOSPITALS ALL LOCATED IN CENTRAL IOWA. BENEFITS OF THE AFFILIATION ARE NUMEROUS AND INCLUDE: A. SHARING OF BEST PRACTICES B. SAVINGS ON GROUP PURCHASING AGREEMENTS C. SAVINGS THROUGH GROUP CONTRACTING FOR NUMEROUS SERVICES D. ACCESS TO NUMEROUS HEALTH CARE EXPERTS E. ACCESS TO PROVIDERS OF ALL TYPES AND SPECIALTIES F. ACCESS TO COMPARATIVE REPORTING G. SUPPORT FOR HUMAN RESOURCES |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KINCAID | ||||||||||||||
| CEO | $257,895 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $16,284 | $0 | $274,179 | $0 | $0 | $0 |
| DAVID KERMODE | ||||||||||||||
| SURGEON | $390,612 | $0 | $11,250 | $0 | $1,815 | $0 | $5,600 | $0 | $16,535 | $0 | $425,812 | $0 | $0 | $0 |
| MARTHA ERRTHUM | ||||||||||||||
| PHYSICIAN | $238,296 | $0 | $0 | $0 | $1,514 | $0 | $14,666 | $0 | $15,323 | $0 | $269,799 | $0 | $0 | $0 |
| THOMAS HOEHNS | ||||||||||||||
| PHYSICIAN | $233,854 | $0 | $24,676 | $0 | $1,676 | $0 | $5,139 | $0 | $16,535 | $0 | $281,880 | $0 | $0 | $0 |
| EARL MCKEEVER | ||||||||||||||
| PHYSICIAN | $215,133 | $0 | $15,000 | $0 | $1,676 | $0 | $8,758 | $0 | $18,405 | $0 | $258,972 | $0 | $0 | $0 |
| SHANNON REMMINGTON | ||||||||||||||
| PHYSICIAN | $225,500 | $0 | $15,000 | $0 | $1,759 | $0 | $14,464 | $0 | $22,296 | $0 | $279,019 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART II: | FormAndLineReferenceDesc |
| Explanation | KEVIN KINCAID, CEO, WAS PAID BY AN UNRELATED ORGANIZATION, MERCY MEDICAL CENTER - DES MOINES. MERCY MEDICAL CENTER HAS A MANAGEMENT AGREEMENT WITH KNOXVILLE COMMUNITY HOSPITAL INC. KNOXVILLE COMMUNITY HOSPITAL PAYS MERCY MEDICAL CENTER FOR THE COMPENSATION OF THE CEO/ADMINISTRATOR. THE AMOUNT OF COMPENSATION PAID BY MERCY MEDICAL CENTER TO KEVIN KINCAID FOR HIS SERVICES AS CEO TO KNOXVILLE COMMUNITY HOSPITAL WAS $257,895. MERCY MEDICAL CENTER IS PART OF CATHOLIC HEALTH INITIATIVES. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| CITY OF KNOXVILLE IOWA | |||||||
| A | 426004843 | 2014-09-20 | $8,650,000 | REFINANCE INDEBTEDNESS INCURRED TO RENOVATE FACILITIES AND PURCHASE EQUIP. | 0 | 0 | 0 |
| MARION COUNTY IOWA | |||||||
| B | 421182528 | 2014-09-20 | $8,650,000 | FINANCE RENOVATION OF FACILITIES AND PURCHASE EQUIP. | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $323,724 | $8,650,000 | $128,143 | $6,527,480 | $1,994,377 | 2016 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $159,859 | $8,650,000 | $128,143 | $7,161,857 | 2016 | 0 | 0 | Yes (1) | Yes (1) | $1,360,000 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0.00060 | 0.00060 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART II, COLUMN A, LINE 11: | $1,994,377 FOR OTHER PROCEEDS WERE SPENT TO REFUND THE 2012 BONDS THAT WERE CALLED ON AUGUST 20, 2014. |
| SCHEDULE K, PART II, COLUMN B, LINE 12: | $1,360,000 OF THE BOND ISSUE PRICE WAS NEVER DRAWN UPON AND THERE WILL NEVER BE ANY MONEY BORROWED UPON OR SPENT FROM THIS AMOUNT. |
| SCHEDULE K, PART II, COLUMNS A AND B, LINE 13: | THE PROJECT WAS DONE AS A PHASE IN PROJECT WITH MULTIPLE AREAS RENOVATED AND NEW AREAS BUILT. THE ENTIRE PROJECT WAS CONSIDERED COMPLETED BY JUNE 3, 2016. |
| SCHEDULE K, PART III, COLUMNS A AND B, LINE 2: | DURING FISCAL YEAR 2017, THE HOSPITAL RENTED ONE HALL OF THE NEW CLINIC TO VISITING SPECIALITY DOCTORS WHO WERE CHARGED RENT BY THE HOUR/DAY. |
| SCHEDULE K, PART III, COLUMNS A AND B, LINE 4: | DURING FISCAL YEAR 2017, THE HOSPITAL RENTED ONE HALL OF THE NEW CLINIC TO VISITING SPECIALITY DOCTORS WHO WERE CHARGED RENT BY THE HOUR/DAY. THE HIGHEST NUMBER OF VISITING DOCTORS USING THE SPACE IN THE NEW CLINIC BUILDING DURING THE FISCAL YEAR 2017 WAS 8, BUT THE TIME SPENT WAS INTERMITTENT AND MOSTLY ONLY DURING 4 DAYS OF THE WEEK. BY THE END OF 2018, THE HOSPITAL EXPECTS THAT NONE OF THE NEW CLINIC SPACE WILL BE LEASED. THE HOSPITAL ANTICIPATES THAT NEARLY ALL OF THE LEASED SPACE BY SPECIALTY DOCTORS WILL BE CONVERTED TO CONTRACT PROVIDER AGREEMENTS OR MOVED TO A NON-BOND FINANCED AREA. THE HOSPITAL WILL HAVE ALL CONTRACT PROVIDER AGREEMENTS IN THE NEW CLINIC REVIEWED BY BOND COUNSEL TO ENSURE THAT THE CONTRACTS MEET THE SAFE HARBOR REQUIREMENTS FOR SERVICE AND MANAGEMENT CONTRACTS, THEREBY RESULTING IN NO PRIVATE USE IN THE NEW CLINIC. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANNON REMMINGTON | PersonNm |
| Relationship With Org | HIGHEST COMPENSATED EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | COMPENSATION | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $72,000 | OriginalPrincipalAmt |
| Balance Due | $28,701 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $28,701 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | KNOXVILLE COMMUNITY HOSPITAL CONTRACTS WITH MERCY MEDICAL CENTER - DES MOINES FOR OVERSIGHT OF MANAGEMENT SERVICES. MERCY MEDICAL CENTER PROVIDES A FULL-TIME HOSPITAL CHIEF EXECUTIVE OFFICER/ADMINISTRATOR TO PROVIDE MANAGEMENT SERVICES AND ADMINISTRATIVE DIRECTION. KNOXVILLE COMMUNITY HOSPITAL PAYS MERCY MEDICAL CENTER FOR THE COMPENSATION OF THE CEO/ADMINISTRATOR. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE CFO AND CEO PRIOR TO BEING FILED, IT IS REVIEWED BY THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING, WHICH MAY OCCUR AFTER FORM 990 HAS BEEN FILED WITH IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE OFFICER REVIEWS THE POLICIES AND UPDATES THEM ANNUALLY. THE COMPLIANCE TEAM MEETS QUARTERLY TO REVIEW ALL COMPLIANCE AREAS AND CONFLICT OF INTEREST IS ONE OF THOSE AREAS. THE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND MEMBERS DO NOT VOTE ON AREAS OF CONFLICT. THE COMPLIANCE OFFICER ATTENDS SPECIAL TRAININGS ON COMPLIANCE REGULATIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | PER HUMAN RESOURCE POLICIES, KNOXVILLE COMMUNITY HOSPITAL UTILIZES THE IHA WAGE SURVEY AND COMPARATIVE ANALYSIS AND MARKET RATES. MOST WAGES ARE ADJUSTED WHEN THE BOARD OF DIRECTORS APPROVES PAY INCREASE PERCENTAGES. KNOXVILLE COMMUNITY HOSPITAL HOPES TO INSTITUTE A NEW PAY FOR PERFORMANCE PLAN IN THE NEAR FUTURE. |
| FORM 990, PART VI, SECTION C, LINE 19 | KNOXVILLE COMMUNITY HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST AT ORGANIZATION'S ADMINISTRATIVE OFFICES DURING NORMAL BUSINESS HOURS. |
| FORM 990, PART IX, LINE 11G | OUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 2,302,994. MANAGEMENT AND GENERAL EXPENSES 153,436. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,456,430. NURSING SERVICES: PROGRAM SERVICE EXPENSES 144,228. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 144,228. EMERGENCY ROOM SERVICES: PROGRAM SERVICE EXPENSES 1,542,432. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,542,432. PHYSICAL THERAPY SERVICES: PROGRAM SERVICE EXPENSES 844,903. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 844,903. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED DURING THE YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KNOXVILLE HOSPITAL & CLINICS FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 SOUTH LINCOLN STREET | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50138 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900126510 | EIN |
| Primary Activities | SUPPORT FOR KNOXVILLE COMMUNITY HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KNOXVILLE COMMUNITY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |