2016-03-15T12:27:07-05:00 2015-04-30 BKD LLP 360 E 8TH AVE STE 201 PO BOX 1196 BOWLING GREEN KY 421021196 990 2014-05-01 610471581 TRIGG COUNTY HOSPITAL INC % CHRISTOPHER WALKLEY TRIG 2705223215 254 MAIN ST CADIZ KY 42211 JOHN SUMNER CEO 2705223215 2016-03-15 true KIM SCIFRES P01316095 2707810111 2014 2016-08-17 19:52:53Z JOHN SUMNER CEO 254 MAIN STREET CADIZ KY 42211 15798848 false X WWW.TRIGGHOSPITAL.ORG X 1952 KY TO PROVIDE QUALITY HEALTHCARE SERVICES IN a caring and cost-effective manner. WE PLEDGE TO MEET STANDARDS OF EXCELLENCE WHILE CONTINUOUSLY IMPROVING THE VALUE OF OUR SERVICE. 12 12 219 0 0 0 627686 653754 14856659 14967984 4176 7654 76392 162426 15564913 15791818 0 0 0 0 8541846 8619059 0 0 0 6871952 6957366 15413798 15576425 151115 215393 9363159 13140337 6676357 10238142 2686802 2902195 TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AND COST-EFFECTIVE MANNER. IN ACHIEVING OUR MISSION, WE PLEDGE TO MEET STANDARDS OF EXCELLENCE WHILE CONTINUOUSLY IMPROVING THE VALUE OF OUR SERVICE. false false 14083219 14973993 Our mission is to provide quality healthcare services in a caring and cost-effective manner. In achieving our mission, we pledge to meet standards of excellence while continuously improving the value of our service. The Hospital provides inpatient, outpatient, and emergency care services to patients in the Trigg County, Kentucky area. 14083219 true true false true false false false false false false true false false false true false false false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 36 0 true 219 true false false false false false false false false false false X 12 12 false false false false false false false true true false false false true true true true true true true false KY X CHRISTOPHER WALKLEY 2705223215 254 MAIN STREET CADIZ KY 42211 X BOB NOEL BOARD MEMBER 1.0 0.0 X 0 0 0 CHRISTY OLIPHANT BOARD MEMBER 1.0 0.0 X 0 0 0 CLARA BETH HYDE BOARD MEMBER 1.0 0.0 X 0 0 0 GEORGE RADFORD SECRETARY/TREASURER 1.0 0.0 X X 0 0 0 JESSE THOMAS VICE CHAIRMAN 1.0 0.0 X X 0 0 0 JOE NICHOLS BOARD MEMBER 1.0 0.0 X 0 0 0 MALLORY LAWRENCE BOARD MEMBER 1.0 0.0 X 0 0 0 MELISSA HALE BOARD MEMBER 1.0 0.0 X 0 0 0 MICHAEL GROSS DMD CHAIRMAN 1.0 0.0 X X 0 0 0 MIKE WRIGHT BOARD MEMBER 1.0 0.0 X 0 0 0 STEPHANIE PERRY BOARD MEMBER 1.0 0.0 X 0 0 0 WILLIAM ALEXANDER MD BOARD MEMBER 1.0 0.0 X 0 0 0 ALISA COLEMAN PART-YEAR CEO 40.0 0.0 X 212278 0 5504 DAVID SHORE PART-YEAR CEO 40.0 0.0 X 0 0 0 DIANA PHILLIPS CFO 40.0 0.0 X 90789 0 2823 DAVID RUTLAND DIRECTOR OF PHARMACY 40.0 0.0 X 135676 0 4317 HOLLY MCCORMICK NURSE PRACTITIONER 40.0 0.0 X 123881 0 3421 KAREN MIRACLE DIRECTOR OF REHAB 40.0 0.0 X 101192 0 3076 663816 0 19141 4 false true false BLUEGRASS PHYSICIANS PO BOX 674579 DETROIT MI 48267 ER PHYSICIANS 1459592 DIAMOND HELATHCARE CORPORATION PO BOX 85050 RICHMOND VA 23285 BEHAVIORAL HEALTH 387470 CPSI 6600 WALL ST MOBILE AL 36695 BILLING/EHR SUPPORT 349148 COMPHEALTH PO Box 972651 DALLAS TX 75397 HEALTHCARE STAFFING 249811 SYSTEMS SOLUTIONS 115 CARLISLE COURT PADUCAH KY 42001 IT EUQIPMENT SUPPORT 199657 7 601900 51854 653754 Net Patient Service Revenue 621110 14312030 14312030 340B Program Revenue 621110 348219 348219 EHR INCENTIVE 900099 307735 307735 14967984 7654 7654 0 0 33943 7030 26913 0 26913 26913 0 0 0 0 Life Line 900099 6009 6009 Cafeteria 900099 40561 40561 All Other Misc Revenue 900099 88943 88943 135513 15791818 14973993 164071 0 0 0 0 335247 335247 0 6487963 6327807 160156 100176 92903 7273 1195642 1108832 86810 500031 463726 36305 214159 214159 6243 6243 0 2299 2299 0 0 2865592 2806712 58880 49157 49157 566205 548008 18197 287249 287249 0 302690 290817 11873 71315 17612 53703 0 0 142108 142108 0 804831 804831 228639 228639 Medical Supplies 674362 668325 6037 Accounting Collections 188364 188364 Maintenance & Repair 167395 167395 Provider Tax 131599 131599 255159 173839 81320 15576425 14083219 1493206 0 397606 199494 141776 129580 0 0 2322693 2672970 0 0 0 0 2122 2150 125547 143018 197750 135674 17176151 7318700 5990176 9857451 0 0 0 0 0 0 0 0 185489 0 9363159 13140337 2708597 2685293 0 0 10715 0 0 0 0 0 0 0 3488736 8105967 0 0 468309 -553118 6676357 10238142 X 5402489 5083955 -2715687 -2181760 0 0 2686802 2902195 9363159 13140337 215393 X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X false false false false false false false false true 2299 2299 false false SCH. C, PART II-B, LINE I LOBBY EXPENSES -------------- A PORTION OF THE ORGANIZATION'S KHA & AHA DUES ARE USED FOR LOBBYING ACTIVITIES. 66000 66000 6028645 2508733 3519912 11081506 4809967 6271539 9857451 0 DUE TO THIRD PARTY PAYERS -553118 -553118 true true true X true X 100 true true true false true true 602846 222837 380009 0.02460 2060519 1883133 177387 0.01150 2663365 2105970 557396 0.03610 40992 40992 0.00270 40992 40992 0.00270 2704357 2105970 598388 0.03880 7 6662 6662 0.00040 7 6662 6662 0.00040 true 1006461 5523376 5534695 -11319 X true true 1 1 TRIGG COUNTY HOSPITAL INC 254 MAIN STREET CADIZ KY 42211 X X X TRIGG COUNTY HOSPITAL INC 1 false false true X X X X X X X X X 13 true false false true X HTTP://TRIGGHOSPITAL.ORG X true 13 true HTTP://TRIGGHOSPITAL.ORG false false true X 100 100 X X true true X true X X true X false X X X true X false false PART V, LILNE 5 CHNA COMMUNITY INPUT -------------------- TRIGG COUNTY SENT A CHNA SURVEY OUT TO THE LOCAL POPULATION FOR ANY RESIDENT TO COMPLETE. 135 RESPONSES TO THIS SURVEY WERE RECEIVED FROM AREA RESIDENTS. IN ADDITION, CONSULTATION WITH 34 LOCAL EXPERTS OCCURRED VIA AN INTERNET BASED SURVEY DURING A PERIOD BEGINNING JANUARY 20, 2013 AND ENDING JANUARY 31, 2013. INFORMATION RELATED TO THE EXPERTS' INPUT IS INCLUDED IN THE CHNA AT http://www.trigghospital.org/docs/Trigg_County_Hospital_Community_Health_N eeds_Assessment_(not_marked_as_draft).pdf?sub=Community+Health+Needs+Asses sment PART V, LINE 11 CHNA NEEDS ADDRESSED -------------------- TRIGG COUNTY IDENTIFIED THE NEEDS OF THE COMMUNITY AS EITHER LOW PRIORITY OR HIGH PRIORITY AND DETERMINED THAT THE BEST USE OF TRIGG COUNTY HOSPITAL'S RESOURCES IS TO FOCUS ON RESOLVING OR IMPROVING HIGHER PRIORITY NEEDS RATHER THAN ATTEMPTING TO RESPOND TO EVERYTHING WITH SMALL, PERHAPS INEFFECTIVE, EFFORTS. PART V, LINE 10 IMPLEMENTATION STRATEGY ----------------------- THE IMPLEMENTATION STRATEGY IS AVAILABLE AT http://www.trigghospital.org/docs/Trigg_County_Hospital_Community_Health_N eeds_Assessment_(not_marked_as_draft).pdf?sub=Community+Health+Needs+Asses sment PART I, LINE 7 COST OF CHARITY CARE -------------------- COST OF CHARITY CARE WAS CALCULATED WTIH A COST TO CHARGE RATIO USING WORKSHEET 2. COST OF MEDICAID WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. PART III, LINE 8 COSTING ------- TRIGG COUNTY HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED FROM MEDICARE AT 101% OF COST RELATED TO CARING FOR MEDICARE PATIENTS. MEDICARE REVENUES AND COSTS REPORTED ON LINES 5 AND 6 ARE BASED ON THE MEDICARE COST REPORT. PART III, LINE 9B DEBT COLLECTION --------------- THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE OR FINANCIAL ASSISTANCE. PART VI, LINE 2 NEEDS ASSESSMENT ---------------- TRIGG COUNTY HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT WHICH WAS ADOPTED BY THE BOARD OF DIRECTORS ON APRIL 29, 2013. TRIGG COUNTY HOSPITAL IS ALWAYS WILLING AND AVAILABLE TO MEET THE NEEDS OF THE COMMUNITY AS THEY ARISE. ADDITIONALLY, TRIGG COUNTY HOSPITAL ASSISTS OTHER AGENCIES, AS NEEDED, TO MEET THE HEALTH AND WELFARE NEEDS OF THE COMMUNITY. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ----------------------------------------------- UNINSURED AND UNDERINSURED PATIENTS ARE PROVIDED WITH INFORMATION ABOUT THE CHARITY CARE PROGRAM. TRIGG COUNTY HOSPITAL CONTRACTS WITH DISABILITY MEDICAL CONSULTANTS (DMC) TO CONTACT EACH OF THESE IDENTIFIED PATIENTS AND PROVIDE THEM WITH INFORMATION ON HOW TO GET QUALIFIED FOR MEDICAID OR HOW TO ENROLL IN INSURANCE PROGRAMS AVAILABLE THROUGH THE AFFORDABLE CARE ACT. PART VI, LINE 4 COMMUNITY INFORMATION --------------------- TRIGG COUNTY, KENTUCKY IS A RURAL COMMUNITY WITH A POPULATION ESTIMATED AT 14,293. TRIGG COUNTY IS LOCATED IN WESTERN KENTUCKY JOINING THE LAND BETWEEN THE LAKES INCLUDING LAKE BARKLEY AND KENTUCKY LAKE. DUE TO OUR LOCATION, TRIGG COUNTY IS A GREAT RETIREMENT COMMUNITY AND AS SUCH APPEALS TO MANY PEOPLE ACROSS THE COUNTRY. APPROXIMATELY 20.5% OF TRIGG COUNTIANS ARE AGE 65 AND OLDER. TRIGG COUNTY HAS BEEN DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P). THE 2012 MEDIAN HOUSEHOLD INCOME IS RIGHT AT THE AVERAGE FOR KENTUCKIANS (APPROXIMATELY $40K); HOWEVER, WELL BELOW THE AVERAGE FOR THE UNITED STATES AT APPROXIMATELY $50K. TRIGG COUNTY'S ESTIMATED PREMATURE DEATH (LIFE LOST PRIOR TO AGE 75) IS 35% HIGHER THAN THE UNITED STATES AVERAGE AND 10% HIGHER THAN THE STATE AVERAGE, POTENTIALLY ATTRIBUTABLE TO A HIGHER NUMBER OF LUNG/BRONCHUS AND COLORECTAL CANCERS. FINALLY, APPROXIMATELY 18% OF TRIGG COUNTIANS HEALTH INSURANCE IS COVERED THROUGH KENTUCKY MEDICAID AND APPROXIMATELY 21% ARE UNINSURED. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH ----------------------------- TRIGG COUNTY HOSPITAL'S DEDICATED STAFF VOLUNTEER FOR NUMEROUS CAUSES PROMOTING HEALTH AND WELFARE FOR TRIGG COUNTIANS INCLUDING: RELAY FOR LIFE, BREAST IMAGING LUNCH & LEARN, HEART HEALTH LUNCH & LEARN, BREAST IMAGING PRESENTATIONS, KIDS HEALTH FAIR, BREAST CANCER AWARENESS EVENTS, OSTEOPOROSIS SCREENINGS, BACK TO SCHOOL SCREENINGS AND BEHAVIORAL HEALTH TRANSPORTATION. ADDITIONALLY, HOSPITAL STAFF ARE INVOLVED IN SUMMER HEALTH CAMP, COMMUNITY READER DAYS, CHILDREN'S CHRISTMAS TREE DECORATING, TEACHERS BACK TO SCHOOL BREAKFAST, MEET & GREET TEACHERS & PARENTS NIGHT, COMMUNITY EDUCATION ADVISORY COUNCIL, BETA NU AND THE TRIGG COUNTY CHAMBER OF COMMERCE. TRIGG 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. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK AND SERVES EVERYONE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL RESEARCHES AND COMPLETES NUMEROUS GRANT APPLICATIONS APPLICABLE TO PROMOTING THE HEALTH OF OUR COMMUNITY. PART V, LINE 22 AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS ------------------------------------------- PATIENTS QUALIFYING FOR DSH HAVE THEIR STAY WRITTEN OFF. THOSE THAT DO NOT ARE CHARGED FOR THE CARE AND HAVE THE OPTION TO SET UP A PAYMENT PLAN IF NEEDED. X X false false false false false false false false false ALISA COLEMAN PART-YEAR CEO 176070 0 36208 0 0 0 5504 0 0 0 217782 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990 ------------------ A COPY OF THE FORM 990 WAS NOT PROVIDED TO THE BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING OF THE CONFLICT OF INTEREST POLICY --------------------------------------------- THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. ALL EMPLOYEES, STAFF, OFFICERS AND BOARD MEMBERS ARE COVERED BY THIS POLICY. EACH YEAR, THE BOARD MEMBERS ARE ASKED TO SIGN A CONFLICT OF INTEREST STATEMENT. THE HOSPITAL HAS POLICIES AND PROCEDURES IN PLACE THAT WILL BE FOLLOWED SHOULD A CONFLICT OF INTEREST ARISE. A RECORD OF THE PROCEEDINGS WHERE CONFLICTS ARE ADDRESSED IS KEPT ON FILE ONCE REVIEWED. FORM 990, PART VI, SECTION C, LINE 19 MAKING DOCUMENTS AVAILABLE TO THE PUBLIC ---------------------------------------- A LEGAL AD IS PUBLISHED ANNUALLY TO ADVISE OF THE AVAILABILITY OF AUDITED FINANCIAL STATEMENTS AT THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS FOR DETERMINING COMPENSATION ------------------------------------ BOARD OF DIRECTORS REVIEWS THE CEO COMPENSATION ANNUALLY. THE LAST REVIEW OF THE CEO'S COMPENSATION WAS APRIL 2015. FROM 990, PART VII, LINE 1 PART YEAR CEO ------------- ALISA COLEMAN WAS PART-YEAR CEO UP UNTIL 1/30/2015. DAVID SHORE TOOK OVER AS INTERIM CEO ON 2/2/2015. FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL PURCHASED SERVICES TOTAL FEES:2539973 FORM 990 PART IX LINE 11G DESCRIPTION:ADMIN PURCHASED SERVICES TOTAL FEES:266739 FORM 990 PART IX LINE 11G DESCRIPTION:ADMIN PURCHASED SERVICES TOTAL FEES:58880 TRIGG COUNTY HOSPITAL FOUNDATION INC 254 MAIN STREET CADIZ KY 42211 061805018 EDUCATION KY 501(c)(3) 7 NA false TRIGG COUNTY PUBLIC HOSPITAL CORPORATION PO BOX 672 CADIZ KY 42211 611336530 GOV UNIT KY 501(a) N/A NA false false false false false false false false false false false false false false false false false false false false