2016-11-11T07:56:35-06:00 2015-12-31 540504608 BROWN EDWARDS & COMPANY LLP 124 NEWMAN AVENUE HARRISONBURG VA 22801 990 2015-01-01 540505913 BATH COMMUNITY HOSPITAL BATH 5408397000 POST OFFICE DRAWER Z HOT SPRINGS VA 24445 TIM PISTELL CHAIRMAN 5408397000 2016-11-10 1 JAMES R FRIES P01320612 5404346736 2016-11-01 2015 2017-02-10 21:41:12Z TIM PISTELL POST OFFICE DRAWER Z HOT SPRINGS VA 24445 21166872 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. 10 10 179 0 0 0 3928138 5025748 15480007 15440580 33745 -23342 416228 666747 19858118 21109733 0 0 0 0 10716321 10863653 0 0 0 10494068 8654991 21210389 19518644 -1352271 1591089 26854809 28058699 19006926 18619727 7847883 9438972 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 16350088 16075540 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. 16350088 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 1 0 0 0 0 0 0 0 1 1 0 0 0 1 54 0 1 179 1 0 0 0 0 0 0 0 0 0 0 X 10 10 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 WILEY KLING DIRECTOR 1.00 0.50 X 0 0 0 WILLIAM BRATTON DIRECTOR 1.00 0.50 X 0 0 0 MICHAEL BOST PHYSICIAN, DIRECTOR 40.00 0.50 X 122925 0 38320 JAMES REDINGTON PHYSICIAN, DIRECTOR 40.00 0.50 X 189619 0 59670 SARAH MCWILLIAMS 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 DASTGIR QURESHI DIRECTOR 1.00 0.50 X 0 0 0 LAURENS SARTORIS DIRECTOR 1.00 0.50 X 0 0 0 AMORY MELLEN III DIRECTOR 1.00 0.50 X 0 0 0 RUTH RODGERS DIRECTOR 1.00 0.50 X 0 0 0 MEL HERWALD DIRECTOR 1.00 0.50 X 0 0 0 PETER FARAONE 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 TIM PISTELL SECRETARY 1.00 0.50 X X 0 0 0 DAVID TROAST CHAIR (JAN-APRIL) 5.00 0.50 X X 0 0 0 KATHY LANDRETH CEO 40.00 0.50 X 150055 0 42695 GREG GUTMEIR CFO, TREASURER 40.00 0.50 X 141684 0 11343 JEFFREY MCCRAY PHYSICIAN 40.00 X 192611 0 42524 WILLIAM PEARSON PHARMACIST 40.00 X 149605 0 20326 LEVI RIZK PHYSICIAN 40.00 X 165788 0 51807 DOUG HOLROYD DIR OF PHARMACY 40.00 X 154832 0 31637 PATRICIA FOUTZ EX DIR CLINICAL SUPPORT & DEV 40.00 X 115076 0 40252 JASON PARET FORMER CEO 0.00 X 254615 0 12065 1636810 0 350639 13 1 1 0 NIELSEN BUILDERS INC 3588 EARLY RD HARRISONBURG VA 24059 CONSTRUCTION CONTRACTORS 3618339 CARDINAL HEALTH 110 INC C/O BANK OF AMERICA ATLANTA GA 30384 HEALTHCARE SERVICES 1707999 CPSI PO BOX 850309 MOBILE AL 36685 COMPUTER AND BILLING SERVICES 692271 THE ERX GROUP LLC 9724 KINGSTON PIKE STE 406 KNOXVILLE TN 37922 ER CONTRACT DOCTORS 665362 STAFF CARE INC PO BOX 281923 ATLANTA GA 30384 STAFFING AGENCY 374047 5 127285 7686 4890777 5025748 OTHER PROFESSIONAL SERVICES 621300 17257623 17257623 OTHER NURSING SERVICES 621300 3756156 3756156 DAILY PATIENT SERVICES 621300 2554852 2554852 CHARITY CARE 621300 -1594709 -1594709 CONTRACTUAL ADJUSTMENTS 621300 -6533342 -6533342 15440580 24837 24837 40747 8960 31787 31787 31787 48179 -48179 -48179 -48179 MEANINGFUL USE REIMBURSEMENT 621300 612677 612677 MISC CAFETERIA AND DIETARY REVENU 621300 19747 19747 MEDICAL TRANSCRIPTS 621300 2179 2179 357 357 634960 21109733 16075540 0 8445 1258126 645669 612457 7800789 7233476 567313 247097 229127 17970 973826 903004 70822 583815 541357 42458 168922 168922 44759 44759 47407 47407 1822677 1249590 573087 120461 3555 116906 142593 125451 17142 137519 14420 123099 368816 364011 4805 40640 33966 6674 1301180 1301180 205573 3569 202004 SUPPLIES 2467903 2446583 21320 EQUIPMENT RENTAL & MAIN 583514 514057 69457 PROVISION FOR BAD DEBTS 298946 298946 DUES AND SUBSCRIPTIONS 174583 75724 98859 729498 366403 363095 19518644 16350088 3168556 0 1899252 3488674 4533143 349039 1931231 1863359 347152 309120 527363 644830 493454 602150 29626828 9545303 16343332 20081525 587388 501463 192494 218539 26854809 28058699 2851576 2464377 16155350 16155350 19006926 18619727 X 6453064 6453064 1394819 2985908 0 0 7847883 9438972 26854809 28058699 1591089 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 648918 648918 17895183 5321046 12574137 415585 244618 170967 5511147 3623654 1887493 5155995 355985 4800010 20081525 20817505 8960 8960 20808545 63 301125 301188 21109733 19226417 8961 8961 19217456 63 301125 301188 19518644 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 8,960. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 298,946. OTHER AMOUNTS NETTED ON FINANCIAL STATEMENTS 2,179. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 8,960. ROUNDING 1. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 298,946. OTHER AMOUNTS NETTED ON FINANCIAL STATEMENTS 2,179. 1 1 1 X 1 X 1 1 1 0 1 1 1 875368 875368 0.04480 1 191517 191517 0.00980 2 1066885 1066885 0.05460 114 1619 14062 14062 0.00070 37 488 21885 21885 0.00110 151 2107 35947 35947 0.00180 153 2107 1102832 1102832 0.05640 2 3545 3545 0.00020 2 3545 3545 0.00020 1 298946 13343526 6094347 7249179 X 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 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 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. 1 1 - BATH COMMUNITY REHAB & WELLNESS CENTER PO DRAWER Z HOT SPRINGS VA 24445 REHAB AND WELLNESS 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 0 1 X X X X 0 0 0 0 0 0 0 0 0 MICHAEL BOST PHYSICIAN, DIRECTOR 122925 0 0 0 0 0 24447 0 13873 0 161245 0 0 0 JAMES REDINGTON PHYSICIAN, DIRECTOR 189619 0 0 0 0 0 33942 0 25728 0 249289 0 0 0 KATHY LANDRETH CEO 150055 0 0 0 0 0 17497 0 25198 0 192750 0 0 0 GREG GUTMEIR CFO, TREASURER 141684 0 0 0 0 0 2559 0 8784 0 153027 0 0 0 JEFFREY MCCRAY PHYSICIAN 192611 0 0 0 0 0 15484 0 27040 0 235135 0 0 0 WILLIAM PEARSON PHARMACIST 149605 0 0 0 0 0 11542 0 8784 0 169931 0 0 0 LEVI RIZK PHYSICIAN 165788 0 0 0 0 0 25682 0 26125 0 217595 0 0 0 DOUG HOLROYD DIR OF PHARMACY 154832 0 0 0 0 0 11547 0 20090 0 186469 0 0 0 PATRICIA FOUTZ EX DIR CLINICAL SUPPORT & DEV 115076 0 0 0 0 0 30051 0 10201 0 155328 0 0 0 JASON PARET FORMER CEO 254615 0 0 0 0 0 0 0 12065 0 266680 0 254615 0 PART I, LINE 1A RESIDENCE FOR PERSONAL USE WAS PROVIDED TO MICHAEL BOST (8 MONTHS) AND KATHY LANDRETH (4 MONTHS) WHICH WAS HOSPITAL-OWNED PROPERTY. IN ADDITION TO THIS, HOUSING PAYMENTS OF $5,600 WERE MADE ON BEHALF OF KATHY LANDRETH FOR 8 MONTHS AT NON-HOSPITAL-OWNED PROPERTIES. PART I, LINE 1B HOUSING BENEFITS WERE PROVIDED PER INDIVIDUAL EMPLOYMENT AGREEMENTS. DR JAMES REDINGTON FORMER BOARD MEMBER 68400 WORKED AS AN CONTRACT EMPLOYEE VIA BATH COUNTY FAMILY PRACTICE. 0 FORM 990, PART VI, SECTION B, LINE 11 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 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 11B, 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 127285 CASH