OHIO COUNTY HOSPITAL CORPORATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- OHIO COUNTY HOSPITAL CORPORATION (EIN 31-1131099)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-15
- IRS object ID
- 201722279349303607
- Schema version
- 2015v3.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-15T16:05:17-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621046406 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON HICKEY & MURCHISON PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 OLAN MILLS DRIVE | AddressLine1Txt |
| City | CHATTANOOGA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37421 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311131099 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OHIO COUNTY HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OHIO | BusinessNameControlTxt |
| Phone | 2702987411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1Txt |
| City | HARTFORD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42347 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELLIE SHOUSE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2702987411 | PhoneNum |
| Signature | 2017-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BARRY R HUGGINS | PreparerPersonNm |
| PTIN | P00627334 | PTIN |
| Phone | 4237560052 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHELLIE SHOUSE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1Txt |
| City | HARTFORD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42347 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,171,853 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OHIOCOUNTYHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES, MAKING A DIFFERENCE IN THE LIVES OF THE PEOPLE WE SERVE BY PROVIDING POSITIVE LIFE-CHANGING EXPERIENCES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 536 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $31,909 | PYContributionsGrantsAmt |
| CY Contributions Grants | $36,475 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,674,165 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,101,752 | CYProgramServiceRevenueAmt |
| PY Investment Income | $17,753 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,123 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,661,561 | PYOtherRevenueAmt |
| CY Other Revenue | $3,023,503 | CYOtherRevenueAmt |
| PY Total Revenue | $37,385,388 | PYTotalRevenueAmt |
| CY Total Revenue | $38,171,853 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,197,172 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,818,631 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,490,694 | PYOtherExpensesAmt |
| CY Other Expenses | $17,000,918 | CYOtherExpensesAmt |
| PY Total Expenses | $36,687,866 | PYTotalExpensesAmt |
| CY Total Expenses | $38,819,549 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $697,522 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$647,696 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,433,598 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,329,515 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,827,294 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,370,907 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,606,304 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,958,608 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES, MAKING A DIFFERENCE IN THE LIVES OF THE PEOPLE WE SERVE BY PROVIDING POSITIVE LIFE-CHANGING EXPERIENCES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $34,866,835 | ExpenseAmt |
| Revenue | $38,098,802 | RevenueAmt |
| Desc | THE MISSION OF OHIO COUNTY IS TO MAKE A DIFFERENCE IN THE LIVES OF OTHERS BY CARING, SERVING, AND EDUCATING INDIVIDUALS RELATIVE TO THEIR SPECIFIC HEALTH NEEDS. WE BELIEVE THAT THROUGH THESE ACTIONS, THE GENERAL HEALTH OF OHIO COUNTY HOSPITAL IS THE FRONTLINE OF COMMUNITY HEALTHCARE, PROVIDING A SAFETY NET 24 HOURS A DAY THROUGH OUR INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. IN ORDER TO MEET THE CHANGING NEEDS OF THE COMMUNITY AND IMPROVE THE ACCESS TO HEALTH CARE, WE HAVE EXPANDED OUR SERVICES TO INCLUDE PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. AND WHILE PATIENTS BENEFIT FROM OUR BEING CLOSE BY, ULTIMATELY IT IS THE WHOLE COMMUNITY THAT PROSPERS FROM OUR PRESENCE. THE HOSPITAL'S POSITIVE IMPACT ON THE COMMUNITY EXTENDS WELL BEYOND THE FOUR WALLS OF THE FACILITY. OUR COMMUNITY BENEFIT INCLUDES NOT ONLY THE COST OF PROVIDING CARE TO THE UNINSURED AND INDIGENT BUT ALSO BY IDENTIFYING UNMET COMMUNITY OR PUBLIC HEALTH NEEDS AND SEEKING TO ADDRESS THEM. EXAMPLES OF SUCH EFFORTS INCLUDING SUPPLYING CHILDHOOD IMMUNIZATION VACCINES TO OUR LOCAL HEALTH DEPARTMENT AT NO CHARGE. BECOMING A SMOKE-FREE FACILITY, AND OFFERING FREE SMOKING CESSATION COURSES SEVERAL TIMES A YEAR TO ALL COMMUNITY MEMBERS. OHIO COUNTY HOSPITAL WAS THE FOUNDING MEMBER OF A LOCAL HEALTH COALITION WHOSE FOCUS IS TO IMPLEMENT PREVENTATIVE HEALTH ACTIVITIES TO COMBAT THE LACK OF PHYSICAL ACTIVITY AND THE PREVELENCE OF OBESITY IN OUR AREA. WHETHER IT'S THROUGH THE PEOPLE WE EMPLOY, THE LOCAL BUSINESSES WE USE, OR THE CHARITIES AND COMMUNITY ACTIVITIES WE SUPPORT, WE ARE COMMITTED TO MAKING THE OHIO COUNTY AREA A HEALTHIER PLACE TO LIVE AND WORK. DURING 2015, THE HOSPITAL PROVIDED HEALTH CARE SERVICES TO OHIO COUNTY KENTUCKY AND SURROUNDING AREAS, INCLUDING INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. OHIO COUNTY HOSPITAL PROVIDED $128,523 OF CHARITY CARE THROUGH ITS CHARITY CARE PROGRAM. | Desc |
| Total Program Service Expenses | $34,866,835 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 536 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 8 | 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 | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | 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 |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELLIE SHOUSE | PersonNm |
| Phone | 2702985495 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1Txt |
| City | HARTFORD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42347 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JANE CANARY | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JONATHAN SHREWSBURY OD | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM DUKE | |||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KELLY ROE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CARLA WALLACE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GERALD WESTERFIELD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LLOYD SPIVEY | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSHUA SKIBBA | |||||||
| CARDIOLOGIST/CMO | 40.00 | Yes (X) | Yes (X) | $422,957 | $0 | $53,475 | |
| BRUCE DURHAM | |||||||
| MEDICAL STAFF REPRESENTATIVE | 2.00 | Yes (X) | $252,558 | $0 | $27,480 | ||
| ATHENA MINOR | |||||||
| CHIEF CLINICAL OFFICER | 40.00 | Yes (X) | $81,568 | $0 | $15,617 | ||
| MUKESH DESAI | |||||||
| UROLOGIST | 40.00 | $628,738 | $0 | $57,614 | Yes (X) | ||
| CHARLES RICCIO | |||||||
| GASTROENTEROLOGIST | 40.00 | $538,461 | $0 | $55,780 | Yes (X) | ||
| BENJAMIN SMITH | |||||||
| PHYSICIAN | 40.00 | $825,675 | $0 | $7,246 | Yes (X) | ||
| STEVEN MILLS | |||||||
| PHYSICIAN | 40.00 | $437,719 | $0 | $28,149 | Yes (X) | ||
| CHARLES JARBOE | |||||||
| PHYSICIAN ER | 40.00 | $353,180 | $0 | $39,769 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,540,856 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $285,130 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EMCARE PHYSICIAN SERVICES | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ER PHYSICIANS | $522,987 |
| ORTHEPEDIC & SPORTS MEDICINE | |||||
| 2831 NEW HARTFORD RD | OWENSBORO | KY | 42303 | ORTHEPEDIC SURGERIES | $303,339 |
| QUOROM HEALTH RESOURCES | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TN | 37027 | MANAGEMENT FEES | $280,986 |
| GEORGE GILLIAM MD | |||||
| 2100 SOUTH STRATFORD DRIVE | OWENSBORO | KY | 42301 | PHYSICIAN SURGICAL | $169,954 |
| ELIZABETH OTTMAN MD | |||||
| 3663 FIELDS ROAD | OWENSBORO | KY | 42303 | OB GYN SERVICES | $130,019 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $500 | GovernmentGrantsAmt |
| All Other Contributions | $35,975 | AllOtherContributionsAmt |
| Total Contributions | $36,475 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICES | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $35,101,752 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,101,752 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,101,752 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,123 | TotalRevenueColumnAmt |
| Exclusion | $10,123 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $26,453 | 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 | $26,453 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,453 | TotalRevenueColumnAmt |
| Exclusion | $26,453 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PHARMACY SALES | 446110 | $2,383,838 | $2,383,838 |
| MISCELLANEOUS INCOME | 621300 | $452,886 | $452,886 |
| WELLNESS PROGRAM | 900099 | $85,056 | $85,056 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $75,270 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,270 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,997,050 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,171,853 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,098,802 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,576 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $853,654 | TotalAmt |
| Program Services | $853,654 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,952,042 | TotalAmt |
| Program Services | $16,832,052 | ProgramServicesAmt |
| Management And General | $1,119,990 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,692 | TotalAmt |
| Program Services | $94,323 | ProgramServicesAmt |
| Management And General | $10,369 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,671,239 | TotalAmt |
| Program Services | $1,569,258 | ProgramServicesAmt |
| Management And General | $101,981 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,237,004 | TotalAmt |
| Program Services | $1,162,784 | ProgramServicesAmt |
| Management And General | $74,220 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,588 | TotalAmt |
| Management And General | $287,588 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,571 | TotalAmt |
| Program Services | $3,997 | ProgramServicesAmt |
| Management And General | $46,574 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,000 | TotalAmt |
| Management And General | $60,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,354,788 | TotalAmt |
| Program Services | $2,762,736 | ProgramServicesAmt |
| Management And General | $592,052 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,729 | TotalAmt |
| Program Services | $65,729 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,470 | TotalAmt |
| Program Services | $104,093 | ProgramServicesAmt |
| Management And General | $27,377 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,208,573 | TotalAmt |
| Program Services | $1,782,415 | ProgramServicesAmt |
| Management And General | $426,158 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,079 | TotalAmt |
| Program Services | $91,669 | ProgramServicesAmt |
| Management And General | $48,410 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,854 | TotalAmt |
| Program Services | $179,854 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $898,142 | TotalAmt |
| Program Services | $898,142 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $514,012 | TotalAmt |
| Management And General | $514,012 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND DR | $5,994,996 | $5,994,996 | |
| BAD DEBT | $2,064,633 | $2,064,633 | |
| TAXES AND LICENSES | $479,989 | $479,989 | |
| OTHER SUPPLIES | $182,253 | $112,954 | $69,299 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $388,241 | TotalAmt |
| Program Services | $293,546 | ProgramServicesAmt |
| Management And General | $94,695 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,819,549 | TotalAmt |
| Program Services | $34,866,835 | ProgramServicesAmt |
| Management And General | $3,952,714 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,338,379 | BOYAmt |
| EOY | $1,523,810 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $370,851 | BOYAmt |
| EOY | $373,231 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,949,736 | BOYAmt |
| EOY | $5,849,648 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $942,305 | BOYAmt |
| EOY | $521,974 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,077,421 | BOYAmt |
| EOY | $1,095,523 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,875 | BOYAmt |
| EOY | $210,900 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,402,370 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,111,961 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,184,390 | BOYAmt |
| EOY | $7,290,409 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,641 | BOYAmt |
| EOY | $464,020 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,433,598 | BOYAmt |
| EOY | $17,329,515 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,124,680 | BOYAmt |
| EOY | $2,853,642 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,015,000 | BOYAmt |
| EOY | $2,865,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,008,124 | BOYAmt |
| EOY | $1,668,772 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $679,490 | BOYAmt |
| EOY | $983,493 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,827,294 | BOYAmt |
| EOY | $8,370,907 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,606,304 | BOYAmt |
| EOY | $8,958,608 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,606,304 | BOYAmt |
| EOY | $8,958,608 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,433,598 | BOYAmt |
| EOY | $17,329,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$647,696 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 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 | $2,874 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,874 | 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 | THE HOSPITAL PAYS DUES TO THE KENTUCKY HOSPITAL ASSSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $530,032 | OtherCostOrOtherBasisAmt |
| Book Value | $530,032 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,562,223 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,570,447 | DepreciationAmt |
| Book Value | $3,991,776 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,817,542 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,143,501 | DepreciationAmt |
| Book Value | $2,674,041 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $492,573 | OtherCostOrOtherBasisAmt |
| Depreciation | $398,013 | DepreciationAmt |
| Book Value | $94,560 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,290,409 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY SETTLEMENTS | $627,170 |
| RETIREMENT BENEFITS | $356,323 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $983,493 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $38,171,853 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,171,853 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $38,171,853 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $38,819,549 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $38,819,549 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $38,819,549 | TotalExpensesPerForm990Amt |
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 AND A SIMILAR PROVISION OF STATE LAW. THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740-10 "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES" WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS WITHIN THE FINANCIAL STATEMENTS. THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2016 AND 2015. AS OF SEPTEMBER 30, 2016 AND 2015, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTIONS. WITH A FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2013. | 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 | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $513,397 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $90,304 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $423,093 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,854,057 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,545,026 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,309,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,367,454 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,635,330 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,732,124 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10150 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,035 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $46,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,035 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $46,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,413,489 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,635,330 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,778,159 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10280 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $956,642 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $58,551 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,910,104 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,846,369 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $63,735 | 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 | 0 | 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 | OHIO COUNTY HOSPITAL CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1Txt |
| City | HARTFORD | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42347 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 1629007430 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| 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 | OHIO COUNTY HOSPITAL CORPORATION | 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 |
| CHNA Conducted | 12 | 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.OHIOCOUNTYHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.OHIOCOUNTYHOSPITAL.COM | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| OHIO COUNTY HOSPITAL CORPORATION | PART V, SECTION B, LINE 5: GREEN RIVER DISTRICT HEALTH DEPARTMENT (GRDHD) PARTNERED WITH UNIVERSITY OF KENTUCKY'S APPALACHIA PUBLIC HEALTH TRAINING CENTER TO PERFORM COMMUNITY HEALTH NEED ASSESSMENTS IN OHIO COUNTY USING THE MAPP PROCESS. THE MAPP PROCESS INCLUDED IDENTIFYING COMMUNITY PARTNERS. A COMPLETED SEARCH OF EXISTING HEALTHCARE RELATED INFORMATION AND DATA FROM PUBLIC INFORMATION SOURCES. PARTNERS MET IN AN INITIAL PUBLIC HEALTH FORUM DESIGNED TO REVIEW KEY HEALTH RELATED STATISTICS AND ANALYSIS FOR THE COUNTY, COMPLETED A PAPER SURVEY THAT WAS DISTRIBUTED IN LOCAL HEALTH DEPARTMENT CLINICS AND HAD AN ONLINE SURVEY, HELD A SECOND MEETING OF COMMUNITY PARTNERS TO EVALUATE ANALYSIS PREVIOUSLY COMPLETED AND CONSIDER RESULTS OF SURVEYS. |
| OHIO COUNTY HOSPITAL CORPORATION | PART V, SECTION B, LINE 18D: THE ONLY FINANCIAL AID PROGRAM IS WHAT THE STATE OFFERS AS THE "DSH" PROGRAM. THE HOSPITAL USE AND OUTSIDE COMPANY-DMC WHO DETERMINES IF ALL OF THE PRIVATE PAY PATIENTS FIRST ARE ELIGIBLE FOR MEDICAID AND IF THEY ARE NOT THEY DETERMINE IF THEY ARE ELIGIBLE FOR THE STATE INDIGENT PROGRAM. IF THEY ARE ELIGIBLE FOR THE STATE PROGRAM THE ENTIRE BALANCE IS WRITTEN OFF. THE HOSPITAL DOES NOT HAVE ANY KIND OF OTHER FAP OR SEPARATE CHARITY CARE POLICY. IF THE PRIVATE PAY PATIENTS ARE ELIGIBLE FOR EITHER OF THE TWO PROGRAMS, THE HOSPITAL HAVE BEGAN OFFERING (OCTOBER 2011), A PRIVATE PAY DISCOUNT WHICH INITIALLY DISCOUNTS 40% OFF THE PATIENT'S ACCOUNT BALANCE. ALL OF THE PRIVATE PAY PATIENTS RECEIVE 3 STATEMENTS, 2 LETTERS AND SOMETIMES A OTHER LETTER BEFORE BEING SENT TO OUR COLLECTIONS AGENCY. THE COLLECTION AGENCY THEN DETERMINES THE ABILITY TO PAY AND THEY TAKE ACTIONS BASED ON THE RESULTS OF THEIR FINDINGS. |
| OHIO COUNTY HOSPITAL CORPORATION | PART V, SECTION B, LINE 20E: ADMITTING CLERKS PROVIDE EACH UNINSURED PATIENT A CHARITY CARE APPLICATION AND ENCOURAGE HER TO COMPLETE THE FORM. IT MUST BE DOCUMENTED THAT THE PATIENT HAS NO CURRENT VALID INSURANCE COVERAGE AND IS NOT ELIGIBLE TO APPLY FOR PUBLIC ASSISTANCE OR OTHER INSURANCE. THE PATIENT MUST MEET THE CRITERIA ESTABLISHED BY THE STATE TO QUALIFY FOR THE CHARITY CARE PROGRAM. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,064,633. |
| PART III, LINE 4: | EXPLANATION FOR HOW BAD DEBT IS CALCULATED IS PROVIDED IN THE FOOTNOTE OF THE FINANICIALS.ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT THE HOSPITAL EXPECTS TO COLLECT. THE HOSPITAL MAINTAINS ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE INABILITY OF ITS PATIENTS TO MAKE REQUIRED PAYMENTS. MANAGEMENT CONSIDERS THE FOLLOWING FACTORS WHEN DETERMINING THE COLLECTABILITY OF PATIENT ACCOUNTS: PAYOR CREDIT-WORTHINESS, PAST TRANSACTION HISTORY WITH THE PAYOR, CURRENT ECONOMIC INDUSTRY TRENDS, AND CHANGES IN PAYOR PAYMENT TERMS. IF THE FINANCIAL CONDITION OF THE HOSPITAL'S PAYORS OR PATIENTS WERE TO DETERIORATE, ADVERSELY AFFECTING THEIR ABILITY TO MAKE PAYMENTS, ADDITIONAL ALLOWANCES WOULD BE REQUIRED. BASED ON MANAGEMENT'S ASSESSMENT, THE HOSPITAL PROVIDES FOR ESTIMATED UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO EARNINGS AND A CREDIT TO ALLOWANCE. BALANCES THAT REMAIN OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. |
| PART III, LINE 8: | THE METHODOLOGY USED TO DETERMINE THE AMOUNT IN LINE 7 WAS THE COST TO CHARGE RATIO. |
| PART III, LINE 9B: | ALL ACCOUNTS MOVE THROUGH THE REGISTRATION, MEDICAL CODING AND INSURANCE BILLING PROCESS. IF THE PATIENT HAS AN INSURANCE OR GOVERNMENT PLAN THAT PAYER WILL BE BILLED. ONCE THEY PAY, THE ACCOUNT IS REVIEWED FOR CORRECT BALANCE. THEN CPSI ASSIGNS A CYCLE CODE TO EACH ACCOUNT WHICH DRIVES WHEN A STATEMENT WILL BE ISSUED. THE STATEMENTS THEN FOLLOW IN 28 DAY CYCLES. EACH PATIENT SHOULD RECEIVE AT LEAST 3 STATEMENTS AND 2 LETTERS. WITH THIS CYCLE EVERY PATIENT WILL RECEIVE STATEMENTS FOR GREATER THAN 120 DAY PERIOD. IN THE EVENT THAT THE PATIENT MAKES ANY PAYMENT AT ALL, THE STATEMENT CYCLE IS SET BACK TO THE BEGINNING.A PATIENT WITH NO INSURANCE GOES THROUGH REGISTRATION, A REVIEW FOR ANY POSSIBLE PAYER AND KENTUCKY DSH PROGRAM. ONCE IT HAS BEEN DETERMINED THAT THERE IS NO OTHER PAYER SOURCE, THE DSH APPLICATIONS ARE SENT TO DMS CONSULTANTS FOR REVIEW OF POTENTIAL MEDICAID OR DSH APPROVAL. DMC NOTIFIES OHIO COUNTY HOSPITAL IF THE PATIENT HAS EITHER INSURANCE, MEDICAID OR HAS BEEN APPROVED FOR THE DSH PROGRAM. ADJUSTMENTS ARE MADE ACCORDINGLY FROM THESE FINDINGS. IF NO INSURANCE AND NOT QUALIFIED FOR ANY PROGRAMS A DENIAL IS SENT TO THE PATIENT.THE PRIVATE PAY PATIENTS ARE ALSO RECEIVING THE SAME BILLING CYCLE AS ALL OTHER PAYERS. DURING THIS CYCLE WE ALSO RECEIVE INCOMING CALLS AND PATIENT WALK IN'S, AS WELL AS MAKING PHONE CALLS AS TIME PERMITS FOR ADDITIONAL ATTEMPTS TO COLLECT.ALL ACCOUNTS ARE DOCUMENTS AS STATEMENTS, LETTERS AND PHONE CALL ATTEMPTS ARE MADE AT THE ATTEMPT TO COLLECT THE BALANCE OF THE ACCOUNT.IN THE EVENT THAT OHIO COUNTY HOSPITAL STAFF HAS BEEN UNABLE TO COLLECT THE OUTSTANDING DEBT, ACCOUNTS ARE TURNED OVER TO AN OUTSIDE COLLECTION AGENCY. THE AGENCY THEN FOLLOWS AS DIRECTED BY OCH TO ATTEMPT FOR AN ADDITIONAL 120 DAYS OR NO PAYMENT WITHIN THE LAST 12 MONTHS. THEIR ATTEMPTS ALSO INCLUDES LETTERS, PHONE CALLS AND PLACED ON CREDIT REPORTING SYSTEMS.IN THE EVENT THAT THE COLLECTION AGENCY HAS BEEN UNSUCCESSFUL AT THE COLLECTION, THE ACCOUNTS WILL BE DEEMED UNCOLLECTIBLE, CLOSED AND RETURNED FROM CREDIT REPORTING AND THEN CANCELED BACK TO HOSPITAL. HOSPITAL STAFF THEN PLACES A NOTE ON THAT ACCOUNT THAT IT HAS BEEN DEEMED UNCOLLECTIBLE. HOSPITAL OR COLLECTION AGENCY MAKES NO FURTHER ATTEMPTS AT COLLECTION AT THIS POINT.HOSPITAL COMPILES A REPORT FOR THE UNCOLLECTIBLE DEDUCTIBLE AND CO INSURANCE THAT HAVE BEEN DEEMED IN THE SAME COST REPORTING FISCAL YEAR PERIOD. THIS REPORT IS PROVIDED TO CMS WHEN EVER NECESSARY. MOST COMMONLY ATTACHED TO THE COST REPORT. |
| PART VI, LINE 2: | IN DECEMBER 2012, OHIO COUNTY HOSPITAL, IN CONJUNCTION WITH THE OHIO COUNTY HEALTH COALITION, GREEN RIVER DISTRICT HEALTH DEPARTMENT AND OTHER KEY COMMUNITY STAKEHOLDERS, CONDUCTED A PLANNING RETREAT TO REVIEW THE GREEN RIVER COMMUNITY HEALTH ASSESSMENT HEALTH IMPROVEMENT PLAN. THIS DOCUMENT IS A COMPREHENSIVE COLLECTION AND ANALYSIS OF DATA REGARDING HEALTH ISSUES AND NEEDS BROKEN DOWN BY COUNTY FOR GREEN RIVER DEVELOPMENT DISTRICT (GRADD). THE INFORMATION FOR THE REPORT WAS OBTAINED BY UTILIZATION OF A COMMUNITY HEALTH ASSESSMENT PROCESS BASED ON MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP).IN OHIO COUNTY, THE MAPP PROCESS INCLUDED THE FOLLOWING KEY STEPS:COMMUNITY PARTNERS WERE IDENTIFIED FROM THE OHIO COUNTY HEALTH COALITION, OTHER HEALTH CARE AGENCIES, LOCAL GOVERNMENT, SCHOOLS, BUSINESSES, CIVIC ORGANIZATIONS, AND VOLUNTEERS FROM THE GENERAL PUBLIC.COMPLETED A SEARCH OF EXISTING HEALTH CARE-RELATED INFORMATION AND DATA FROM PUBLIC INFORMATION SOURCES; THE PARTNERS MET IN AN INITIAL PUBLIC HEALTH FORUM DESIGNED TO REVIEW KEY HEALTH-RELATED STATISTICS FOR THE COUNTY AND TO COMPLETE A STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS (SWOT) ANALYSIS FOR THE COUNTY;COMPLETED A PAPER SURVEY, DISTRIBUTED IN LOCAL HEALTH DEPARTMENT CLINICS, AND AN ON-LINE SURVEY, TO OBTAIN WIDER INPUT FROM INDIVIDUALS INTO THE COMMUNITY'S HEALTH NEEDS.HELD A SECOND MEETING OF COMMUNITY PARTNERS TO EVALUATE THE SWOT ANALYSIS PREVIOUSLY COMPLETED AND TO CONSIDER RESULTS FROM THE COMPLETED SURVEYS. THIS FORUM WORKED TO IDENTIFY AND GROUP SIMILAR HEALTH RELATED CONCERNS FOR THE COUNTY AS FOLLOWS: 1) IMPROVE COMMUNITY LIFESTYLE CHOICES; 2) INCREASE HEALTH CARE ACCESS; AND 3) REDUCE SUBSTANCE ABUSE. THE OHIO COUNTY HEALTH COALITION WAS DETERMINED TO BE THE ORGANIZATION WITH PRIME RESPONSIBILITY FOR ADDRESSING THESE STRATEGIC HEALTH CARE INITIATIVES ON AN ON-GOING BASIS.A GREEN RIVER COMMUNITY HEALTH ASSESSMENT HEALTH IMPROVEMENT PLAN WAS DEVELOPED FOR THE REGION AND EACH OF THE DISTRICT'S COUNTIES. THIS PLAN WAS REVIEWED WITH THE OHIO COUNTY HEALTH COALITION AND OTHER COMMUNITY PARTNERS.OHIO COUNTY HOSPITAL USED THE INFORMATION COLLECTED FROM THE MAPP'S SURVEY PROCESS TO DETERMINE WHICH HEALTH NEEDS COULD BE MOST IMPACTED BY COLLABORATION BETWEEN OUR FACILITY AND THE OHIO COUNTY HEALTH COALITION. IT WAS DETERMINED THAT THE OHIO COUNTY HOSPITAL HAD THE NECESSARY RESOURCES AND ABILITY TO IMPACT THE FOLLOWING HEALTH NEEDS: IMPROVING COMMUNITY LIFESTYLE CHOICES, INCREASE ACCESS TO HEALTHCARE, AND REDUCE SUBSTANCE ABUSE. THESE KEY HEALTHCARE ISSUES ALIGNED WITH THE MISSION AND PRIORITIES OF OHIO COUNTY HOSPITAL AND WERE INCORPORATED INTO THE2013 STRATEGIC PLAN.THE GREEN RIVER ASSESSMENT COMMUNITY PLAN AND OHIO COUNTY HOSPITAL'S STRATEGIC IMPLEMENTATION PLAN WERE ADOPTED BY BOARD RESOLUTION FROM OHIO COUNTY HOSPITAL'S TRUSTEES ON JUNE 13, 2013. THE HEALTH IMPROVEMENT PLAN WAS MADE WIDELY AVAILABLE TO THE COMMUNITY VIA THE HOSPITAL'S WEBSITE, AS WELL AS THROUGH HARD COPIES LOCATED AT THE HOSPITAL'S FRONT DESK. |
| PART VI, LINE 3: | OHIO COUNTY HOSPITAL'S ADMITTING AND BUSINESS OFFICE STAFF PROVIDES CHARITY CARE APPLICATIONS TO ANY PATIENT THAT DOESN'T HAVE INSURANCE DURING THE REGISTRATION PROCESS. IF THE PATIENT DOESN'T COMPLETE THE APPLICATION AT THAT TIME, THEIR DEMOGRAPHIC INFORMATION IS THEN SENT TO AN OUTSIDE COMPANY, DMC, INC, AND THEY DETERMINE IF THE PATIENT IS ELIGIBLE FOR EITHER MEDICAID OR CHARITY CARE. DMC WILL FOLLOW-UP WITH THE PATIENT TO GET ADDITIONAL INFORMATION AS NEEDED. ONCE THE ACCOUNT IS BILLED AND IS IN THE COLLECTION PROCESS, OUR PRIVATE PAY COUNSELORS CHECK EACH ACCOUNT TO MAKE SURE THAT IT HAS BEEN CHECKED FOR INDIGENT CARE ELIGIBILITY. |
| PART VI, LINE 4: | HISTORICALLY 90% OF ALL ADMISSIONS AND 95% OF ALL OUTPATIENT SERVICES PERFORMED AT OHIO COUNTY HOSPITAL ARE PROVIDED TO RESIDENTS OF OHIO COUNTY; 94% OF ALL MEDICARE INPATIENT ADMISSIONS ARE GENERATED FROM THE OHIO COUNTY AREA. THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES THE RESIDENTS OF THE INCORPORATED CITIES OF HARTFORD, BEAVER DAM, ROSINE, FORDSVILLE, HORSE BRANCH AND CROMWELL. OHIO COUNTY IS GEOGRAPHICALLY THE FIFTH LARGEST COUNTY IN KENTUCKY. TOTAL POPULATION AS OF 2013 WAS 23,988.THE PER CAPITA INCOME (MEAN INCOME FOR EVERY MAN, WOMAN, AND CHILD IN A PARTICULAR GROUP) HAS DECREASED FROM THE PREVIOUS YEAR TO $18,409.00 COMPARED TO THE KENTUCKY AVERAGE OF $23,210. OHIO COUNTY IS A DESIGNATED A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVICED AREA / POPULATION (MUA/P). IN 2013, THE PERCENTAGE OF OHIO COUNTY'S POPULATION LIVING BELOW THE POVERTY LEVEL INCREASED TO 20.89%. ACCORDING TO KENTUCKY HEALTH FACTS, THE RATE FOR UNINSURED ADULTS (UNDER 65 YEARS) IS 22%, WHICH IS SECOND HIGHEST IN THE GRADD REGION, AND THE RATE FOR UNINSURED CHILDREN (UNDER 19 YEARS) IS 7%. STATISTICS ALSO REPORT THAT 20% OF ADULTS IN THE OHIO COUNTY EXPERIENCED A TIME IN THE PAST YEAR NEEDED TO SEE A DOCTOR BUT DID NOT BECAUSE OF THE COST. |
| PART VI, LINE 5: | OHIO COUNTY HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS WHO ARE COMMITTED TO THE HEALTH AND WELFARE OF THE COMMUNITY AND DEDICATED TO ENSURING THE VIABILITY OF THE HOSPITAL FOR YEARS TO COME. THE BOARD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA. SURPLUS FUNDS PROVIDE FOR CONTINUITY OF HEALTHCARE SERVICES DURING PERIODS OF ECONOMIC DOWNTURN, RECRUITMENT OF ADDITIONAL PROVIDERS TO IMPROVE THE ACCESS TO HEALTHCARE, AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK AND SERVES ALL CITIZENS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDES REPRESENTATION AND SUPPORT TO THE OHIO COUNTY CHAMBER BOARD OF DIRECTORS, OHIO COUNTY TOURISM, OHIO COUNTY INDUSTRIAL FOUNDATION, AND LEADERSHIP OHIO COUNTY PROGRAM, WHICH ARE ORGANIZATIONS WORKING TOWARDS THE ECONOMIC GROWTH OF OUR AREA. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | KY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOSHUA SKIBBA | ||||||||||||||
| CARDIOLOGIST/CMO | $422,957 | $0 | $0 | $0 | $0 | $0 | $42,344 | $0 | $11,131 | $0 | $476,432 | $0 | $0 | $0 |
| BRUCE DURHAM | ||||||||||||||
| MEDICAL STAFF REPRESENTATIVE | $236,183 | $0 | $16,375 | $0 | $0 | $0 | $21,297 | $0 | $6,183 | $0 | $280,038 | $0 | $0 | $0 |
| MUKESH DESAI | ||||||||||||||
| UROLOGIST | $628,738 | $0 | $0 | $0 | $0 | $0 | $51,431 | $0 | $6,183 | $0 | $686,352 | $0 | $0 | $0 |
| CHARLES RICCIO | ||||||||||||||
| GASTROENTEROLOGIST | $538,461 | $0 | $0 | $0 | $0 | $0 | $50,077 | $0 | $5,703 | $0 | $594,241 | $0 | $0 | $0 |
| BENJAMIN SMITH | ||||||||||||||
| PHYSICIAN | $540,722 | $0 | $284,953 | $0 | $0 | $0 | $0 | $0 | $7,246 | $0 | $832,921 | $0 | $0 | $0 |
| STEVEN MILLS | ||||||||||||||
| PHYSICIAN | $351,062 | $0 | $86,657 | $0 | $0 | $0 | $21,966 | $0 | $6,183 | $0 | $465,868 | $0 | $0 | $0 |
| CHARLES JARBOE | ||||||||||||||
| PHYSICIAN ER | $353,180 | $0 | $0 | $0 | $0 | $0 | $28,638 | $0 | $11,131 | $0 | $392,949 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OHIO COUNTY PUBLIC FACILITIES CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 616000805 | BondIssuerEIN |
| Bond Issued | 2010-09-29 | BondIssuedDt |
| Issue Price | $3,620,000 | IssuePriceAmt |
| Purpose | MEDICAL OFFICE BUILDING CONSTRUCTION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $3,015,000 | TotalProceedsAmt |
| In Reserve Fund | $273,400 | InReserveFundAmt |
| Issuance Costs From Proceeds | $70,000 | IssuanceCostsFromProceedsAmt |
| Substantial Completion | 2011 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (3 entries)
| Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|
| DR BRUCE DURHAM | ||||||
| SIGNON BONUS | Yes (X) | $20,000 | $10,500 | 0 | Yes (1) | Yes (1) |
| DR CHRISTEL MIRANDA | ||||||
| SIGNON BONUS | Yes (X) | $32,814 | $9,115 | 0 | Yes (1) | Yes (1) |
| DR GILBRT LUCENO | ||||||
| SIGNON BONUS | Yes (X) | $32,814 | $9,115 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $28,730 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL CONTRACTS WITH QUORUM HEALTH RESOURCES, INC (QHR) TO PROVIDE MANAGEMENT SERVICES UNDER AN AGREEMENT WHICH EXPIRES IN 2018. THE CONTRACT REQUIRES QHR TO SUPPLY A CHIEF EXECUTIVE OFFICER AND A CHEIF FINANCIAL OFFICER WHOSE SALARY AND BENEFITS COST ARE PASSED DIRECTLY THROUGH TO THE HOSPITAL. THE HOSPITAL'S EXPENSE FOR THE MANAGEMENT FEE TOTALED APPOXIMATELY $287,588 FOR THIS YEAR. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS PROVIDED TO THE FULL BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS ARE COVERED UNDER THIS POLICY AND ANY CONFLICTS ARE RESOLVED AT MONTHLY BOARD MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS RECEIVED A COMPENSATION REVIEW BY QHR AND THE GOVERNING BOARD. OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION RECEIVE ANNUAL REVIEWS BASED ON CURRENT MARKET DATA. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |