HARRISON MEMORIAL HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HARRISON MEMORIAL HOSPITAL (EIN 61-0420440)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-12
- IRS object ID
- 201632259349304008
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-12T16:22:18-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 273858252 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEAN DORTON ALLEN FORD PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 W VINE STREET SUITE 600 | AddressLine1Txt |
| City | LEXINGTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40507 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610420440 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARR | BusinessNameControlTxt |
| Phone | 8592353502 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1210 KY HWY 36 E | AddressLine1Txt |
| City | CYNTHIANA | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 410317498 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHEILA CURRANS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8592353502 | PhoneNum |
| Signature | 2016-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ALLISON C CARTER | PreparerPersonNm |
| PTIN | P01242412 | PTIN |
| Phone | 8592552341 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHEILA CURRANS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1210 KY HWY 36 E | AddressLine1Txt |
| City | CYNTHIANA | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 410317498 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,404,033 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HARRISONMEMHOSP.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1906 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY HEALTH AND MEDICAL CARE TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 424 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $30,549 | PYContributionsGrantsAmt |
| CY Contributions Grants | $41,852 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $37,123,512 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $41,663,388 | CYProgramServiceRevenueAmt |
| PY Investment Income | $35,311 | PYInvestmentIncomeAmt |
| CY Investment Income | $29,168 | CYInvestmentIncomeAmt |
| PY Other Revenue | $541,769 | PYOtherRevenueAmt |
| CY Other Revenue | $568,792 | CYOtherRevenueAmt |
| PY Total Revenue | $37,731,141 | PYTotalRevenueAmt |
| CY Total Revenue | $42,303,200 | 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 | $18,985,529 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,246,236 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,613,194 | PYOtherExpensesAmt |
| CY Other Expenses | $20,929,439 | CYOtherExpensesAmt |
| PY Total Expenses | $37,598,723 | PYTotalExpensesAmt |
| CY Total Expenses | $42,175,675 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $132,418 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $127,525 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $38,929,352 | TotalAssetsBOYAmt |
| Total Assets EOY | $39,829,042 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,686,943 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,343,465 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,242,409 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,485,577 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HARRISON MEMORIAL HOSPITAL EXISTS FOR THE PURPOSE OF PROVIDING HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES OF OUR REGION WITHIN THE CAPABILITIES OF OUR RESOURCES. IN FULFILLING THIS MISSION, WE STRIVE FOR EXCELLENCE IN: THE CARE WE DELIVER; IN PATIENT SAFETY; IN THE FACILITIES WE PROVIDE; IN THE RECRUITMENT, RETENTION, AND DEVELOPMENT OF DEDICATED PHYSICIANS AND PERSONNEL; IN FACILITATING, COORDINATING AND PROVIDING ACCESS TO GENERAL AND SPECIALIZED HEALTH SERVICES THROUGH OUR OWN RESOURCES AND IN COLLABORATION WITH THE RESOURCES OF OTHERS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $36,428,582 | ExpenseAmt |
| Revenue | $41,663,388 | RevenueAmt |
| Desc | THE HOSPITAL PROVIDED HEALTH CARE TO 1,686 IN-PATIENTS, 232 NURSERY PATIENTS AND 58,281 OUT-PATIENTS. THE HOSPITAL HAS A HIGH VOLUME OF MEDICARE AND MEDICAID PATIENTS. THE HOSPITAL TREATS ALL PATIENTS REGARDLESS OF ABILITY TO PAY. HARRISON MEMORIAL HOSPITAL PROVIDED APPROXIMATELY $822,000 OF CHARITY CARE AT COST. | Desc |
| Total Program Service Expenses | $36,428,582 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 76 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 424 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8592353502 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1210 KY HWY 36 E | AddressLine1Txt |
| City | CYNTHIANA | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 410317498 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ALEX BARNETT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GERALD FIELDS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUG HAMPTON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN LAIR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR BRIAN MULBERRY | |||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LARRY WILEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FRAZER LEBUS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE JUDY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL TUCKER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES PETTEY MD | |||||||
| ORTHOPEDIC SURGEON | 40.00 | Yes (X) | $546,374 | $0 | $2,522 | ||
| DR STEPHEN BESSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES SMITH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG WILLS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHEILA CURRANS | |||||||
| CEO | 40.00 | $214,340 | $0 | $14,415 | Yes (X) | ||
| DAVID MELLET | |||||||
| CFO | 40.00 | $147,964 | $0 | $19,782 | Yes (X) | ||
| GERALD HARPEL MD | |||||||
| OB PHYSICIAN | 40.00 | $392,496 | $0 | $14,352 | Yes (X) | ||
| CAMPBELL KARL SCHULSTAD | |||||||
| SURGEON | 40.00 | $290,014 | $0 | $24,614 | Yes (X) | ||
| DR TODD BRADEN REID | |||||||
| SURGEON | 40.00 | $265,013 | $0 | $8,388 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,856,201 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $84,073 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | 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 |
|---|---|---|---|---|---|
| PARKE PHYSICIANS PLLC | |||||
| 155 E MARKET STREET STE 425 | INDIANAPOLIS | IN | 46204 | ER PHYSICIANS | $615,976 |
| COMMUNITY ANESTHESIA OF THE BLUEGRASS | |||||
| 1210 KY HWY 36E | CYNTHIANA | KY | 41031 | ANESTHESIA SERVICES | $530,217 |
| MEDICUS EMERGENCY ROOM SERVICE LLC | |||||
| 22 ROULSTON ROAD | WINDHAM | NH | 03087 | ER PHYSICIANS | $338,146 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 530458 | ATLANTA | GA | 30353 | LAB TESTING | $325,818 |
| DR MICHAEL S GAINEY PLLC | |||||
| 101 WIDGEON COURT | GEORGETOWN | KY | 40324 | ER PHYSICIANS | $241,210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $41,852 | AllOtherContributionsAmt |
| Total Contributions | $41,852 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 623990 | BusinessCd |
| Total Revenue Column | $41,663,388 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,663,388 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $41,663,388 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,412 | TotalRevenueColumnAmt |
| Exclusion | $30,412 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $120,845 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $99,589 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,256 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,256 | TotalRevenueColumnAmt |
| Exclusion | $21,256 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,244 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,244 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,244 | TotalRevenueColumnAmt |
| Exclusion | -$1,244 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/VENDING | 722210 | $195,691 | $195,691 |
| DAY CARE | 624410 | $144,591 | $144,591 |
| PURCHASE DISCOUNTS | 900099 | $63,439 | $63,439 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $143,815 | TotalRevenueColumnAmt |
| Exclusion | $143,815 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $547,536 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,303,200 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,663,388 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $597,960 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $406,779 | TotalAmt |
| Program Services | $342,834 | ProgramServicesAmt |
| Management And General | $63,945 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,482,397 | TotalAmt |
| Program Services | $13,891,364 | ProgramServicesAmt |
| Management And General | $2,591,033 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,078 | TotalAmt |
| Program Services | $317,801 | ProgramServicesAmt |
| Management And General | $59,277 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,842,155 | TotalAmt |
| Program Services | $2,395,368 | ProgramServicesAmt |
| Management And General | $446,787 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,827 | TotalAmt |
| Program Services | $958,961 | ProgramServicesAmt |
| Management And General | $178,866 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,103 | TotalAmt |
| Management And General | $94,103 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,249,887 | TotalAmt |
| Program Services | $3,581,805 | ProgramServicesAmt |
| Management And General | $668,082 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,296 | TotalAmt |
| Program Services | $177,237 | ProgramServicesAmt |
| Management And General | $33,059 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,640 | TotalAmt |
| Program Services | $153,929 | ProgramServicesAmt |
| Management And General | $28,711 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,463 | TotalAmt |
| Program Services | $23,146 | ProgramServicesAmt |
| Management And General | $4,317 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $585,602 | TotalAmt |
| Program Services | $493,545 | ProgramServicesAmt |
| Management And General | $92,057 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,897 | TotalAmt |
| Program Services | $39,525 | ProgramServicesAmt |
| Management And General | $7,372 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $740,593 | TotalAmt |
| Program Services | $740,593 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,633,406 | TotalAmt |
| Program Services | $2,633,406 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $596,177 | TotalAmt |
| Program Services | $502,458 | ProgramServicesAmt |
| Management And General | $93,719 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS & SUPPLIES | $6,507,947 | $5,596,873 | $911,074 |
| BAD DEBT EXPENSE | $1,684,601 | $1,684,601 | |
| OUTSOURCING | $1,509,430 | $1,272,150 | $237,280 |
| KY PROVIDER TAX | $549,795 | $549,795 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,310,602 | TotalAmt |
| Program Services | $1,073,191 | ProgramServicesAmt |
| Management And General | $237,411 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,175,675 | TotalAmt |
| Program Services | $36,428,582 | ProgramServicesAmt |
| Management And General | $5,747,093 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,977,911 | BOYAmt |
| EOY | $2,758,157 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,981,607 | BOYAmt |
| EOY | $5,786,079 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $444,084 | BOYAmt |
| EOY | $518,007 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $839,565 | BOYAmt |
| EOY | $1,012,531 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $744,566 | BOYAmt |
| EOY | $793,407 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $54,523,287 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,181,229 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,444,297 | BOYAmt |
| EOY | $21,342,058 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,325,646 | BOYAmt |
| EOY | $6,441,526 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $316,649 | BOYAmt |
| EOY | $335,389 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $855,027 | BOYAmt |
| EOY | $841,888 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,929,352 | BOYAmt |
| EOY | $39,829,042 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,932,767 | BOYAmt |
| EOY | $3,355,611 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,774,216 | BOYAmt |
| EOY | $15,278,196 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $757,578 | BOYAmt |
| EOY | $1,270,862 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,382 | BOYAmt |
| EOY | $438,796 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,686,943 | BOYAmt |
| EOY | $20,343,465 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,476,567 | BOYAmt |
| EOY | $18,768,973 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $765,842 | BOYAmt |
| EOY | $716,604 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,242,409 | BOYAmt |
| EOY | $19,485,577 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,929,352 | BOYAmt |
| EOY | $39,829,042 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $127,525 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $66,643 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $49,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,885 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,885 | 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 IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE KENTUCKY HOSPITAL ASSOCIATION AND PAID DUES OF $19,719 OF WHICH $3,885 IS ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $333,371 | OtherCostOrOtherBasisAmt |
| Book Value | $333,371 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,699,592 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,181,934 | DepreciationAmt |
| Book Value | $13,517,658 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $530,826 | OtherCostOrOtherBasisAmt |
| Depreciation | $109,902 | DepreciationAmt |
| Book Value | $420,924 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,049,802 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,869,949 | DepreciationAmt |
| Book Value | $6,179,853 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,909,696 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,019,444 | DepreciationAmt |
| Book Value | $890,252 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,342,058 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYORS | $257,612 |
| PHYSICIAN COMMITMENTS | $181,184 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $438,796 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $40,833,831 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $66,643 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $148,589 | OtherRevenueAmt |
| Revenue Not Reported | $215,232 | RevenueNotReportedAmt |
| Revenue Subtotal | $40,618,599 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,684,601 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,684,601 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $42,303,200 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,590,663 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $99,589 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $99,589 | ExpensesNotReportedAmt |
| Expenses Subtotal | $40,491,074 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,684,601 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,684,601 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $42,175,675 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES NETTED AGAINST RENTAL INCOME ON PAGE 1 99,589. INCOME FROM PARTNER'S INVESTMENT IN PAIN MANAGEMENT GROUP 49,000. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED ON FINANCIALS 1,684,601. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES NETTED AGAINST RENTAL INCOME ON PAGE 1 99,589. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED ON FINANCIALS 1,684,601. |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 150.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $831,826 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $831,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01970 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,643,786 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,125,802 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,517,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05970 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,475,612 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,125,802 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,349,810 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07940 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $473,670 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $473,670 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01120 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,159 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,159 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $140 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $140 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $486,969 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $486,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,962,581 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,125,802 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,836,779 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,709,361 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,396,717 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,927,898 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,531,181 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1210 KY HWY 36 EAST | AddressLine1Txt |
| City | CYNTHIANA | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41031 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 14 | 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.HARRISONMEMHOSP.COM | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.HARRISONMEMHOSP.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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 150.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HARRISON MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 5: INDIVIDUALS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH WERE INTERVIEWED DURING THE COURSE OF PREPARING THE COMMUNITY NEEDS ASSESSMENT. THESE INDIVIDUALS INCLUDED BOTH FAMILY SPECIALTY PHYSICIANS AND DIRECTORS OF LOCAL HEALTH DEPARTMENTS OF HARRISON COUNTY AND THE SURROUNDING COUNTIES AND THE MAYOR OF CYNTHIANA. |
| HARRISON MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 11: THE HOSPITAL HAS ADDRESSED THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH ITS IMPLEMENTATION PLAN THAT IS POSTED ON THE HOSPITAL'S WEBSITE AND ATTACHED TO THIS RETURN. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | AMOUNTS WERE DETERMINED USING A COST-TO-CHARGE RATIO DERIVED FROM THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H. |
| PART I, LN 7 COL(F): | $1,709,361 OF BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A) WAS REMOVED FROM THE DENOMINATOR OF THIS CALCULATION PER THE INSTRUCTIONS. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | HARRISON MEMORIAL HOSPITAL IS VERY ACTIVE IN THE COMMUNITY WITH PROMOTING HEALTH EDUCATION. HMH PARTNERS WITH SEVERAL COMMUNITY ORGANIZATIONS TO REACH THE LARGEST AUDIENCE. IN MOST RECENT YEARS, HMH HAS PROVIDED HEALTH FAIRS AND SEMINARS IN SEVERAL COUNTIES LIKE PENDLETON, BRACKEN AND ROBERTSON. BY PROVIDING THESE EVENTS, HMH IS ABLE TO PROVIDE EDUCATION AND SCREENINGS MORE LOCALLY FOR THE RESIDENTS. IN ADDITION, THE EVENTS AID IN BUILDING RELATIONSHIPS WITH COMMUNITY LEADERS AND RESIDENTS. THE EVENTS LIKE HEALTH FAIRS PROVIDE FREE TESTS AND SCREENINGS, WHICH WOULD NORMALLY COST $1200 PER PERSON. THE HEALTH FAIRS PROVIDE AN OPPORTUNITY FOR THE UNDERINSURED AND UNINSURED TO RECEIVE MEDICAL CARE. THE EVENTS ALSO HAVE SEVERAL OPPORTUNITIES TO MEET WITH HEALTH CARE PROFESSIONALS TO DISCUSS HEALTH ISSUES. THE HMH SPONSORED EDUCATIONAL SEMINARS PROVIDE AN OPPORTUNITY FOR INDIVIDUALS TO MEET HEALTH CARE PROFESSIONALS AND DISCUSS MAJOR HEALTH TOPICS. |
| PART III, LINE 2: | BAD DEBT COST REPRESENTS THE EXPENSE THE HOSPITAL INCURRED DUE TO NONPAYMENT OF HOSPITAL CHARGES INCLUDING, BUT NOT LIMITED TO, NONPAYMENT OF MEDICARE COINSURANCE AND DEDUCTIBLE AMOUNTS. THIS EXPENSE IS LISTED AS AN OPERATING EXPENSE ON THE FINANCIAL STATEMENTS.BAD DEBT COST IS CALCULATED BY MULTIPLYING THE BAD DEBT EXPENSE LISTED ON THE FINANCIAL STATEMENTS BY THE COST TO CHARGE RATIO COMPUTED ON WORKSHEET 2. |
| PART III, LINE 8: | ALL THE SHORTFALL REPORTED IN LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. LINE 6 WAS COMPUTED USING REVENUE AMOUNTS LISTED ON THE SETTLEMENT WORKSHEETS ON THE AS-FILED MEDICARE COST REPORT. |
| PART III, LINE 9B: | THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE BASED ON FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AND DISCOUNTED CARE. FOR PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WITH DISCOUNTED CARE, COLLECTION PURSUITS FOR THE DISCOUNTED CHARGES ARE FOLLOWED AS STATED IN OUR PROMPT PAYMENT ON SELF-PAY ACCOUNTS POLICY. |
| PART VI, LINE 2: | THE HOSPITAL COMPLETED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. IN ADDITION, HARRISON MEMORIAL HOSPITAL ASSESSES THE COMMUNITY THROUGH SEVERAL METHODS. THE HMH COMMUNITY CONSISTS OF A SEVEN-COUNTY AREA. HMH HAS TWO BOARD LEVEL COMMITTEES WHO PROVIDE RECOMMENDATIONS TO THE HMH BOARD OF DIRECTORS. PLANNING: MARKET SHARE ENHANCEMENT COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS AND HMH PHYSICIAN STAFF MEMBERS. THE COMMITTEE IS PRESENTED WITH MARKET SHARE DATA OF THE INPATIENT ACTIVITY OF THE HOSPITAL AND OF MAJOR SERVICE LINES LIKE CARDIOLOGY, ORTHOPEDICS. THE DATA INFORMS THE COMMITTEE WHERE PATIENTS IN THE HMH SERVICE AREA CHOOSE TO RECEIVE HEALTHCARE. THE DATA IS EXTRACTED FROM KENTUCKY INFOSUITE EACH QUARTER. THE REPORTS AID THE COMMITTEE IN MAKING DECISIONS IN REGARDS TO THE NEEDS OF THE COMMUNITY. EACH YEAR THE PMSE COMMITTEE HOSTS A STRATEGIC RETREAT INVITING HMH BOARD MEMBERS, PHYSICIAN STAFF MEMBERS AND SENIOR MANAGEMENT TO DISCUSS COMMUNITY NEEDS AND PLANS FOR THE FUTURE. ANOTHER BOARD LEVEL COMMITTEE IS CALLED MEDICAL STAFF DEVELOPMENT. THE COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS, HMH PHYSICIAN STAFF MEMBERS AND COMMUNITY VOLUNTEERS. EACH YEAR THE MEDICAL STAFF DEVELOPMENT COMMITTEE COMPLETES A PHYSICIAN NEEDS ASSESSMENT. THE ASSESSMENT DEMONSTRATES THE PHYSICIAN NEED IN THE AREA BASED ON POPULATION. THE ASSESSMENT IS USED TO FORM A PHYSICIAN RECRUITING PLAN FOR THE FUTURE AND IS RECOMMENDED TO THE BOARD FOR APPROVAL. FINALLY, THE HMH MEDICAL STAFF MEETINGS ARE HELD ONCE A MONTH WHERE MEMBERS OF THE HMH SENIOR MANAGEMENT ALSO ATTEND. WITHIN THESE MEETINGS, THE STAFF MEMBERS DISCUSS PATIENT NEEDS. THE INFORMATION GATHERED AT THESE MEETINGS AID IN THE DECISIONS OF SERVICE LINE ENHANCEMENT. |
| PART VI, LINE 3: | NOTIFICATION ABOUT CHARITY AVAILABLE FROM HARRISON MEMORIAL HOSPITAL, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY HARRISON MEMORIAL HOSPITAL BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, SPECIALTY PHYSICIAN CLINICS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES, AND PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES AS HARRISON MEMORIAL HOSPITAL MAY ELECT. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY HARRISON MEMORIAL HOSPITAL. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE HARRISON MEMORIAL HOSPITAL STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. |
| PART VI, LINE 4: | HARRISON MEMORIAL HOSPITAL SERVES SEVEN COUNTIES IN THE CENTRAL KENTUCKY AREA MAKING IT A REGIONAL FACILITY. THOSE COUNTIES ARE HARRISON, PENDLETON, ROBERTSON, BRACKEN, NICHOLAS, BOURBON AND SCOTT. HMH COMMUNITY IS CONSIDERED IN MOST PARTS RURAL WITH CYNTHIANA BEING ITS LARGEST TOWN IT SERVES WITH A POPULATION AROUND 7,000. THE AREA IS ALSO DESCRIBED AS A BEDROOM COMMUNITY OF LEXINGTON. THE AREA IS A FARMING COMMUNITY WITH SEVERAL STRONG INDUSTRIES BASED IN THE AREA. HMH CONSIDERS ITS SERVICE AREA POPULATION TO BE 35,000. THE DEMOGRAPHIC OF THE COMMUNITIES IS PREDOMINANTLY CAUCASIAN WITH AN AGING POPULATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES PETTEY MD | ||||||||||||||
| ORTHOPEDIC SURGEON | $546,374 | $0 | $0 | $0 | $0 | $0 | $2,522 | $0 | $0 | $0 | $548,896 | $0 | $0 | $0 |
| SHEILA CURRANS | ||||||||||||||
| CEO | $214,340 | $0 | $0 | $0 | $0 | $0 | $6,435 | $0 | $7,980 | $0 | $228,755 | $0 | $0 | $0 |
| DAVID MELLET | ||||||||||||||
| CFO | $147,964 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,782 | $0 | $167,746 | $0 | $0 | $0 |
| GERALD HARPEL MD | ||||||||||||||
| OB PHYSICIAN | $392,496 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,352 | $0 | $406,848 | $0 | $0 | $0 |
| CAMPBELL KARL SCHULSTAD | ||||||||||||||
| SURGEON | $290,014 | $0 | $0 | $0 | $0 | $0 | $10,262 | $0 | $14,352 | $0 | $314,628 | $0 | $0 | $0 |
| DR TODD BRADEN REID | ||||||||||||||
| SURGEON | $265,013 | $0 | $0 | $0 | $0 | $0 | $408 | $0 | $7,980 | $0 | $273,401 | $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 | COUNTY OF HARRISON KY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 616000746 | BondIssuerEIN |
| Bond Issued | 2009-11-13 | BondIssuedDt |
| Issue Price | $17,475,000 | IssuePriceAmt |
| Purpose | REFINANCE SERIES 2005 AND RETIRE THE INTEREST RATE SWAP AGREEMENT | PurposeDesc |
| Defeased | Yes (1) | DefeasedInd |
| On Behalf Of Issuer | Yes (1) | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $17,475,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $95,217 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $79,432 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $17,300,351 | CapitalExpendituresAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | 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 | 0 | 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 |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| PEGGY LAIR | |||
| PEGGY LAIR IS MARRIED TO A BOARD MEMBER | $81,544 | PEGGY LAIR IS EMPLOYED AS THE CONTROLLER FOR THE HOSPITAL | 0 |
| JOHN LAIR | |||
| BOARD MEMBER | $129,050 | PAYMENT TO ATTORNEY ESCROW ACCOUNT FOR PURCHASE OF OFFICE BUILDING IN CARLISLE, KY. | 0 |
| MARY BETH SLADE | |||
| MARY BETH SLADE IS SISTER TO AN OFFICER | $74,520 | MARY BETH SLADE IS AN EMPLOYEE OF THE HOSPITAL | 0 |
| CRISTIN CURRANS | |||
| CRISTIN CURRANS IS DAUGHTER OF AN OFFICER | $35,651 | CRISTIN CURRANS IS AN EMPLOYEE OF THE HOSPITAL | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED, AFTER FILING, IN DETAIL AT THE FINANCE COMMITTEE MEETING WITH BOARD MEMBERS PRESENT. THEY ARE ASKED IF THEY WANT A COPY AND ARE ENCOURAGED TO PERSONALLY VISIT WITH THE CFO TO COVER ANY TOPICS NECESSARY. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, ALL APPLICABLE PERSONNEL SIGN A CONFLICT OF INTEREST STATMENT AND, WHEN NEEDED, IT IS INCORPORATED INTO POLICIES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD CHAIR AND EXECUTIVE COMMITTEE REVIEW THE COMPENSATION ANNUALLY AFTER RECEIPT OF THE AHA ANNUAL SALARY SURVEY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. A NEW PATIENT HANDBOOK HAS BEEN DEVELOPED FOR ALL PATIENTS AND WILL BE HANDED OUT AT OUTPATIENT ADMISSIONS OR AVAILABLE FOR USE IN PATIENT ROOMS. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,581,805. MANAGEMENT AND GENERAL EXPENSES 668,082. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,249,887. |
| FORM 990, PART XI, LINE 9: | CASH FROM PARTNER'S INVESTMENT IN PAIN MANAGEMENT GROUP 49,000. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR. |
| PART VI, SECTION B, LINE 16B | THE ORGANIZATION DOES NOT HAVE A FORMAL, WRITTEN POLICY ON HOW TO EVALUATE PARTICIPATION IN A JOINT VENTURE, HOWEVER, THE ORGANIZATION DID ITS DUE DILEGENCE AND INVOLVED LEGAL COUNSEL TO REVIEW THE NEW PARTNERSHIP FOR PAIN MANAGEMENT SERVICES TO ENSURE THAT THE HOSPITAL'S EXEMPT STATUS WAS NOT AT RISK. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISON MEMORIAL PAIN MANAGEMENT LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1210 KY HWY 36E | AddressLine1Txt |
| City | CYNTHIANA | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41031 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 472547452 | EIN |
| Primary Activities | PAIN MANAGEMENT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $10,825 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $158,872 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH PARTNERSHIP LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1210 KY HWY 36E | AddressLine1Txt |
| City | CYNTHIANA | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41031 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611348611 | EIN |
| Primary Activities | HEALTH CARE PROMOTION | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $97,497 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $347 | ShareOfEOYAssetsAmt |
| Ownership | 0.50000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISON MEMORIAL PAIN MANAGEMENT LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $51,000 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |