2017-11-15T07:41:11-06:00 2016-12-31 540504608 BROWN EDWARDS & COMPANY LLP 124 NEWMAN AVENUE HARRISONBURG VA 22801 990 2016-01-01 540505913 BATH COMMUNITY HOSPITAL BATH 5408397000 POST OFFICE DRAWER Z HOT SPRINGS VA 24445 DEBORAH SHIPMAN CFO 5408397000 2017-11-14 1 JAMES R FRIES P01320612 5404346736 2017-11-14 206.248.228.130 2017-11-14 15:09:13 ES P 6C2E7FE575F144BDACDAF9C1D644CFEFE9CD29DA 51DFD465520EA625141331F6B90939AE6BEDACC4 2016 2021-01-29 14:40:06Z DEBORAH SHIPMAN POST OFFICE DRAWER Z HOT SPRINGS VA 24445 22415574 0 X WWW.BATHHOSPITAL.ORG X 1925 VA BATH COMMUNITY HOSPITAL ACCEPTS PRIMARY RESPONSIBILITY FOR IMPROVING THE HEALTH OF OUR AREA BY PROVIDING HIGH QUALITY, COMPASSIONATE, AND AFFORDABLE HEALTH CARE TO OUR REGION. 12 11 208 0 0 0 5025748 7531190 15440580 14762093 -23342 10428 666747 99820 21109733 22403531 0 6685 0 0 10863653 10726253 0 0 0 8654991 10520103 19518644 21253041 1591089 1150490 28058699 28548393 18619727 17958932 9438972 10589461 TO TAKE PRIMARY RESPONSIBILITY FOR IMPROVING THE HEALTH OF OUR AREA BY PROVIDING HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTH CARE TO OUR REGION. 0 0 17800635 6685 14844671 BATH COMMUNITY HOSPITAL OPERATES A 25-BED CRITICAL ACCESS HOSPITAL, TWENTY-FOUR HOUR EMERGENCY SERVICES, PRIMARY CARE, AS WELL AS A SELECT RANGE OF DIAGNOSTIC SERVICES, REHABILITATIVE SERVICES AND SPECIALTY CLINICS.IN ADDITION, BATH COMMUNITY HOSPITAL HOLDS VARIOUS EVENTS, FREE OF CHARGE, THROUGHOUT THE YEAR THAT BENEFIT THE HEALTH AND WELLNESS OF THE COMMUNITY. IN 2016, THE HOSPITAL HELD 232 DIFFERENT COMMUNITY EVENTS AND SERVED APPROXIMATELY 2,300 PEOPLE. THE HOSPITAL ALSO PROVIDES FINANCIAL ASSISTANCE TO LOW INCOME INDIVIDUALS AND FAMILIES. IN 2016, THE HOSPITAL ALSO PROVIDED 405 PATIENTS WITH FINANCIAL ASSISTANCE, FORGOING REIMBURSEMENT ON SERVICES THAT COST THE ORGANIZATION APPROXIMATELY $653,000 TO PROVIDE. 17800635 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 57 0 1 208 1 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X X THE ORGANIZATION 5408397000 106 PARK DR HOT SPRINGS VA 24445 WILLIAM BRATTON DIRECTOR 1.00 0.50 X 0 0 0 RALPH CLARK DIRECTOR 1.00 0.50 X 0 0 0 SCOTT HETZER DIRECTOR 1.00 0.50 X 0 0 0 WILEY KLING JR DIRECTOR (JAN - APRIL) 1.00 0.50 X 0 0 0 JOHN LOEFFLER DIRECTOR 1.00 0.50 X 0 0 0 JEFFREY MCCRAY PHYSICIAN 40.00 0.50 X 206882 0 42298 SARAH MCWILLIAMS DIRECTOR 1.00 0.50 X 0 0 0 DASTGIR QURESHI DIRECTOR 1.00 0.50 X 0 0 0 R MEADE SNYDER DIRECTOR 1.00 0.50 X 0 0 0 PETER FARAONE CHAIR (JAN-APRIL) 1.00 0.50 X X 0 0 0 TIM PISTELL SECRETARY, CHAIR (APRIL-DEC) 1.00 0.50 X X 0 0 0 GEORGE PHILLIPS VICE CHAIR 1.00 0.50 X X 0 0 0 LAURENS SARTORIS SECRETARY 1.00 0.50 X X 0 0 0 KATHY LANDRETH CEO 40.00 0.50 X 212207 0 28271 GREG GUTMEIR CFO 40.00 0.50 X 139791 0 15548 JOAQUIN BARBARA MEDICAL DIRECTOR 40.00 X 289128 0 27649 VERONICA ORTIZ HOSPITALIST 40.00 X 268734 0 28938 JAMES REDINGTON PHYSICIAN, DIRECTOR 40.00 0.50 X 194656 0 35549 DOUG HOLROYD DIR OF PHARMACY 40.00 X 175208 0 31021 WILLIAM PEARSON PHARMACIST 40.00 X 153870 0 15762 1640476 0 225036 12 0 1 0 NIELSEN BUILDERS INC 3588 EARLY RD HARRISONBURG VA 22801 CONSTRUCTION CONTRACTORS 2082698 THE ERX GROUP LLC 9724 KINGSTON PIKE KNOXVILLE TN 37922 CONTRACT PHYSICIANS 938711 CPSI PO BOX 850309 MOBILE AL 36685 SOFTWARE AND MEDICAL RECORDS 710661 LABRATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB TESTING 214767 SIEMENS MEDICAL SOLUTIONS USA PO BOX 120001 DALLAS TX 75312 MAINTENANCE CONTRACT ON MEDICAL EQUIPMEN 164174 10 2767285 46843 4717062 279402 7531190 OTHER PROFESSIONAL SERVICES 621300 17914853 17914853 OTHER NURSING SERVICES 621300 3552458 3552458 DAILY PATIENT SERVICES 621300 2447618 2447618 CHARITY CARE 621300 -1204356 -1204356 CONTRACTUAL ADJUSTMENTS 621300 -7948480 -7948480 14762093 11863 11863 27850 10608 17242 17242 17242 1435 -1435 -1435 -1435 MISC CAFETERIA AND DIETARY REVENU 621300 73506 73506 MISCELLANEOUS INCOME 621300 6411 6411 MEDICAL TRANSCRIPTS 621300 2661 2661 82578 22403531 14844671 0 27670 X 6685 6685 646345 249180 397165 8173840 7189799 984041 252760 222330 30430 1047375 921283 126092 605933 532985 72948 141955 141955 46633 46633 45110 45110 2304582 1727063 577519 64643 2060 62583 149215 130382 18833 190512 53288 137224 359214 347758 11456 46047 42448 3599 195172 85925 109247 1338235 1338235 213967 7140 206827 SUPPLIES 2530445 2503832 26613 PROVISION FOR BAD DEBTS 1326482 1326482 EQUIPMENT RENTAL & MAIN 709288 631575 77713 DUES AND SUBSCRIPTIONS 231363 104354 127009 627240 377831 249409 21253041 17800635 3452406 0 X 3488674 3396297 349039 148876 1863359 1424914 309120 225957 644830 585104 602150 429098 32716710 10881986 20081525 21834724 501463 411649 218539 91774 28058699 28548393 2464377 1803582 16155350 16155350 18619727 17958932 X 6453064 9194642 2985908 1394819 0 0 9438972 10589461 28058699 28548393 X 1150490 -1 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 673218 673218 24614705 6078745 18535960 415585 286549 129036 6394203 4148799 2245404 618999 367893 251106 21834724 21102571 34977 34977 21067594 110 1335827 1335937 22403531 19952081 34977 34977 19917104 110 1335827 1335937 21253041 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST RECEIPTS 34,977. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 1,326,482. OTHER AMOUNTS NETTED ON FINANCIAL STATEMENTS 9,344. ROUNDING 1. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST RECEIPTS 34,977. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 1,326,482. OTHER AMOUNTS NETTED ON FINANCIAL STATEMENTS 9,344. ROUNDING 1. 1 1 1 X 1 X 1 1 1 0 1 1 1 405 653119 653119 0.03070 1 179777 179777 0.00850 2 405 832896 832896 0.03920 212 1652 15624 15624 0.00070 1 5052 5052 0.00020 19 198 21214 21214 0.00100 232 1850 41890 41890 0.00190 234 2255 874786 874786 0.04110 1 450 1448 1448 0.00010 1 450 1448 1448 0.00010 1 1326482 6568030 7605698 -1037668 X 1 0 1 1 BATH COMMUNITY HOSPITAL 106 PARK DR HOT SPRINGS VA 24445 WWW.BATHHOSPITAL.ORG H1827 VA X X X X BATH COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X WWW.BATHHOSPITAL.ORG X X 1 15 1 WWW.BATHHOSPITAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX 0 1 X 200.000000000000 250.000000000000 X X X 0 1 X X X 1 X WWW.BATHHOSPITAL.ORG X X X X X 1 X 0 X X 1 X 0 0 BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: SINCE THE GREATEST PORTION OF THE ORGANIZATION'S PATIENT AND CUSTOMERS RESIDE IN BATH COUNTY, FOCUS GROUPS, PAPER SURVEYS AS WELL AS AN ONLINE SURVEY WERE UTILIZED TO GATHER INPUT FROM THE COMMUNITY REGARDING COMMUNITY HEALTH NEEDS AND CONCERNS. SPECIAL ATTENTION WAS TAKEN THROUGHOUT THE PRIMARY DATA COLLECTION PROCESS TO ENSURE THE HOSPITAL'S ASSESSMENT TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH. THE FOCUS GROUP MEMBERS INCLUDED REPRESENTATIVES FROM THE MEDICAL COMMUNITY, CIVIC ORGANIZATIONS, BUSINESS OWNERS, FARMERS, PUBLIC HEALTH OFFICIALS, EMTS, FIRE FIGHTERS, CITY AND COUNTY OFFICIALS, SCHOOL PERSONNEL, MENTAL HEALTH PROVIDERS, BATH COUNTY SHERRIFF'S OFFICE PERSONNEL, SUBSTANCE ABUSE AND MENTAL HEALTH COUNSELORS, MINISTERIAL ASSOCIATION MEMBERS, BOARD OF TRUSTEE MEMBERS, HIGH SCHOOL ATHLETES, PATIENTS AND PEOPLE REPRESENTING THE UNINSURED AND UNDERINSURED POPULATION. BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: LOCAL VIRGINIA HEALTH DEPARTMENTBATH COUNTY DEPARTMENT OF SOCIAL SERVICESBATH COUNTY ADMINISTRATIONROCKBRIDGE COUNTY COMMUNITY SERVICESRIVERSIDE HEALTH CENTER BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 7D: FOCUS GROUPS BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: MENTAL HEALTH & SUBSTANCE ABUSE: EXPLORE THE IMPLEMENTATION OF AN INTEGRATED BEHAVIORAL HEALTH PROGRAM IN THE RURAL HEALTH CLINIC. OFFER MENTAL HEALTH FIRST AID CLASS IN THE COMMUNITY. EXPLORE THE USE OF TELE-PSYCHIATRY SERVICES. EXPLORE IMPLEMENTATION OF A SADD (STUDENTS AGAINST DESTRUCTIVE DECISIONS) CLUB. EXERCISE, PREVENTION & EDUCATION: DEVELOP A ROBUST COMMUNITY HEALTH OUTREACH PROGRAM.CHRONIC DISEASE MANAGEMENT IN AN AGING POPULATION: EXPLORE OPPORTUNITY OF PATIENT NAVIGATOR POSITION. PARTNER WITH PRIMARY CARE PROVIDERS.NEEDS NOT BEING ADDRESSED AND WHY: WHILE ALL IDENTIFIED NEEDS ARE IMPORTANT, BATH COMMUNITY HOSPITAL WILL NOT ADDRESS THE NEED FOR PUBLIC TRANSPORTATION IN BATH COUNTY. ALSO, DIALYSIS WILL NOT BE PURSUED AS IT IS NOT CONSIDERED AN UNDERSERVED NEED AS ACCESS TO DIALYSIS CENTERS IS AVAILABLE IN THE NEIGHBORING COMMUNITIES, INCLUDING LOW MOOR AND LEXINGTON, VA. BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 20E: NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION, PRIOR TO DISCHARGE, AND IN COMMUNICATIONS WITH THE INDIVIDUALS REGARDING THEIR BILL. DOCUMENTED THE DETERMINATION OF WHETHER INDIVIDUALS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POICY. 1 1 - BATH COMMUNITY REHAB & WELLNESS CENTER PO DRAWER Z HOT SPRINGS VA 24445 WELLNESS SERVICES, WHICH ARE COHOUSED WITH LICENSED REHAB SERVICES PART I, LINE 3C: WE ALSO CONSIDER ASSETS SUCH AS MONEY IN THE BANK AND ASSETS THAT COULD BE LIQUIDATED INTO CASH, AND WE REVIEW BANK STATEMENTS TO SEE IF MONEY IS FREQUENTLY SPENT ON LUXURY ITEMS INSTEAD OF NEEDED ITEMS. PART I, LINE 7: ALL FIGURES ARE DERIVED FROM THE FINANCIAL STATEMENTS, WHICH ARE PREPARED ON THE INCOME TAX BASIS. THE COST TO CHARGE RATIO FROM WORKSHEET 2 IS USED. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. BALANCES ARE CONSIDERED DELINQUENT WHEN THEY ARE OUTSTANDING FOR 90 DAYS WITH NO ACTIVITY AT WHICH TIME THE BALANCES ARE TRANSFERRED TO A COLLECTION AGENCY AND THE BALANCE IS MOVED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. THE BAD DEBT EXPENSE REPORTED ON SCH H, PART III, LINE 2 IS THE ESTIMATED BAD DEBT ATTRIBUTABLE TO CHARGES ON PATIENT ACCOUNTS. PART III, LINE 8: NONE SHOULD BE TREATED AS A COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS AS DETERMINED BY FILING OF THE CMS 2552-10 COST REPORT. X X X X 0 0 0 0 0 0 0 0 0 JEFFREY MCCRAY PHYSICIAN 206557 0 325 0 0 0 9922 0 32376 0 249180 0 0 0 KATHY LANDRETH CEO 190310 0 21897 0 0 0 9869 0 18402 0 240478 0 0 0 GREG GUTMEIR CFO 125637 0 14154 0 0 0 6414 0 9134 0 155339 0 0 0 JOAQUIN BARBARA MEDICAL DIRECTOR 270053 0 19075 0 0 0 0 0 27649 0 316777 0 0 0 VERONICA ORTIZ HOSPITALIST 263409 0 5325 0 0 0 0 0 28938 0 297672 0 0 0 JAMES REDINGTON PHYSICIAN, DIRECTOR 194331 0 325 0 0 0 9105 0 26444 0 230205 0 0 0 DOUG HOLROYD DIR OF PHARMACY 171650 0 3558 0 0 0 5746 0 25275 0 206229 0 0 0 WILLIAM PEARSON PHARMACIST 153295 0 575 0 0 0 7019 0 8743 0 169632 0 0 0 X 1 279402 ASSESSED VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE BYLAWS GIVE THE EXECUTIVE COMMITTEE FULL AUTHORITY TO OPERATE AND ADMINISTER THE CORPORATION BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND TO ACT IN ALL SITUATIONS EXCEPT AS SPECIFIED IN THE CORPORATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B ALL MEMBERS OF THE BOARD REVIEW A COPY OF THE 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM IS SIGNED ANNUALLY BY ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS USED THE MCCRACKIN GROUP IN THE PAST TO LOOK AT REASONABLENESS OF COMPENSATION. THIS GROUP WAS RECOMMENDED BY VHHA, AND HAS BEEN CONTACTED ON AN AS-NEEDED BASIS BY INDIVIDUAL BOARD MEMBERS. THE BOARD OF DIRECTORS ALSO USE THE VASHHRA REPORT FOR SALARY SURVEY PURPOSES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIANS AND MEDICAL PROFESSIONAL : PROGRAM SERVICE EXPENSES 1,158,918. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,158,918. CONSULTING FEES : PROGRAM SERVICE EXPENSES 7,870. MANAGEMENT AND GENERAL EXPENSES 106,560. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,430. BILLING AND CODING SERVICES : PROGRAM SERVICE EXPENSES 990. MANAGEMENT AND GENERAL EXPENSES 434,676. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 435,666. OTHER OUTSIDE SERVICES : PROGRAM SERVICE EXPENSES 559,285. MANAGEMENT AND GENERAL EXPENSES 36,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 595,568. FORM 990, PART X, LINE 14 TOTAL ASSETS AS REPORTED ON THIS RETURN DIFFER FROM THE AUDITED FINANCIAL STATEMENTS DUE TO SEPARATE REPORTING OF NET LOAN ISSUANCE COSTS OF $411,649. ON THE FINANCIAL STATEMENTS, THESE COSTS ARE NETTED AGAINST THE LIABILITY BALANCE. FORM 990, PART XI, LINE 9: ROUNDING -1. FORM 990, PART XII, LINE 1 THE ORGANIZATION USES INCOME TAX BASIS OF ACCOUNTING. THAT BASIS DIFFERS FROM GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRIMARILY BECAUSE THE HOSPITAL DOES NOT RECORD, AS A PERMANENTLY RESTRICTED ASSET, FUNDS HELD IN TRUST BY OTHERS. THE HOSPITAL ALSO DOES NOT RECORD ITS LONG-TERM INVESTMENTS AND BENEFICIAL INTERESTS AT FAIR VALUE AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE ORGANIZATION DID NOT CHANGE ITS ACCOUNTING METHOD IN CURRENT YEAR. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SELECTION OF AN AUDIT COMMITTEE THAT OVERSEES PREPARATION OF FINANCIAL STATEMENTS AND AUDIT PROCESS. THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS IN CURRENT YEAR. BATH COMMUNITY HOSPITAL FOUNDATION PO DRAWER Z HOT SPRINGS VA 24445 571137401 SUPPORT FUNDRAISING EFFORTS OF BATH COMMUNITY HOSPITAL VA 501(C)(3) LINE 12B, II BATH COMMUNITY HOSPITAL 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 BATH COMMUNITY HOSPITAL FOUNDATION C 2767285 CASH