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OHIO COUNTY HOSPITAL CORPORATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
OHIO COUNTY HOSPITAL CORPORATION (EIN 31-1131099)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-05-15
IRS object ID
201521359349301407
Schema version
2013v4.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-15T08:23:17-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN621046406PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON HICKEY & MURCHISON PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1651 E FOURTH ST STE 200AddressLine1
CityCHATTANOOGACity
StateTNState
ZIP Code37403ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311131099EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HOSPITAL CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlOHIOBusinessNameControlTxt
Phone2702987411PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1
CityHARTFORDCity
StateKYState
ZIP Code42347ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN TICHENORPersonNm
Person TitleCFOPersonTitleTxt
Phone2702987411PhoneNum
Signature2015-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBARRY R HUGGINSPreparerPersonNm
PTINP00627334PTIN
Phone4237560052PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBLAINE PIEPERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1
CityHARTFORDCity
StateKYState
ZIP Code42347ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$34,886,339GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.OHIOCOUNTYHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionTHE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES, MAKING A DIFFERENCE IN THE LIVES OF THE PEOPLE WE SERVE BY PROVIDING POSITIVE LIFE-CHANGING EXPERIENCES.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee471TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$74,136PYContributionsGrantsAmt
CY Contributions Grants$22,564CYContributionsGrantsAmt
PY Program Service Revenue$31,955,727PYProgramServiceRevenueAmt
CY Program Service Revenue$32,549,981CYProgramServiceRevenueAmt
PY Investment Income$8,697PYInvestmentIncomeAmt
CY Investment Income-$7,586CYInvestmentIncomeAmt
PY Other Revenue$2,211,553PYOtherRevenueAmt
CY Other Revenue$2,305,189CYOtherRevenueAmt
PY Total Revenue$34,250,113PYTotalRevenueAmt
CY Total Revenue$34,870,148CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,932,868PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,744,619CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,840,514PYOtherExpensesAmt
CY Other Expenses$15,470,695CYOtherExpensesAmt
PY Total Expenses$33,773,382PYTotalExpensesAmt
CY Total Expenses$35,215,314CYTotalExpensesAmt
PY Revenues Less Expenses$476,731PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$345,166CYRevenuesLessExpensesAmt
Total Assets BOY$18,564,946TotalAssetsBOYAmt
Total Assets EOY$17,675,516TotalAssetsEOYAmt
Total Liabilities BOY$9,310,998TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,766,734TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,253,948NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,908,782NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES, MAKING A DIFFERENCE IN THE LIVES OF THE PEOPLE WE SERVE BY PROVIDING POSITIVE LIFE-CHANGING EXPERIENCES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$31,486,349ExpenseAmt
Revenue$34,806,293RevenueAmt
DescTHE MISSION OF OHIO COUNTY IS TO MAKE A DIFFERENCE IN THE LIVES OF OTHERS BY CARING, SERVING, AND EDUCATING INDIVIDUALS RELATIVE TO THEIR SPECIFIC HEALTH NEEDS. WE BELIEVE THAT THROUGH THESE ACTIONS, THE GENERAL HEALTH OF OHIO COUNTY HOSPITAL IS THE FRONTLINE OF COMMUNITY HEALTHCARE, PROVIDING A SAFETY NET 24 HOURS A DAY THROUGH OUR INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. IN ORDER TO MEET THE CHANGING NEEDS OF THE COMMUNITY AND IMPROVE THE ACCESS TO HEALTH CARE, WE HAVE EXPANDED OUR SERVICES TO INCLUDE PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. AND WHILE PATIENTS BENEFIT FROM OUR BEING CLOSE BY, ULTIMATELY IT IS THE WHOLE COMMUNITY THAT PROSPERS FROM OUR PRESENCE. THE HOSPITAL'S POSITIVE IMPACT ON THE COMMUNITY EXTENDS WELL BEYOND THE FOUR WALLS OF THE FACILITY. OUR COMMUNITY BENEFIT INCLUDES NOT ONLY THE COST OF PROVIDING CARE TO THE UNINSURED AND INDIGENT BUT ALSO BY IDENTIFYING UNMET COMMUNITY OR PUBLIC HEALTH NEEDS AND SEEKING TO ADDRESS THEM. EXAMPLES OF SUCH EFFORTS INCLUDING SUPPLYING CHILDHOOD IMMUNIZATION VACCINES TO OUR LOCAL HEALTH DEPARTMENT AT NO CHARGE. BECOMING A SMOKE-FREE FACILITY, AND OFFERING FREE SMOKING CESSATION COURSES SEVERAL TIMES A YEAR TO ALL COMMUNITY MEMBERS. OHIO COUNTY HOSPITAL WAS THE FOUNDING MEMBER OF A LOCAL HEALTH COALITION WHOSE FOCUS IS TO IMPLEMENT PREVENTATIVE HEALTH ACTIVITIES TO COMBAT THE LACK OF PHYSICAL ACTIVITY AND THE PREVELENCE OF OBESITY IN OUR AREA. WHETHER IT'S THROUGH THE PEOPLE WE EMPLOY, THE LOCAL BUSINESSES WE USE, OR THE CHARITIES AND COMMUNITY ACTIVITIES WE SUPPORT, WE ARE COMMITTED TO MAKING THE OHIO COUNTY ARE A HEALTHIER PLACE TO LIVE AND WORK. DURING 2013, THE HOSPITAL PROVIDED HEALTH CARE SERVICES TO OHIO COUNTY KENTUCKY AND SURROUNDING AREAS, INCLUDING INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. OHIO COUNTY HOSPITAL PROVIDED $679,776 OF CHARITY CARE THROUGH ITS CHARITY CARE PROGRAM. IN ADDITION, THEY PROVIDED $35,533 WORTH OF PROFESSIONAL FEES AND $7,711 OF HOSPITAL/PHYSICIAN CLINIC SERVICES THAT WERE NOT REIMBURSED BY ANY STATE PROGRAMS.Desc
Total Program Service Expenses$31,486,349TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document31IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee471EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldKYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJOHN TICHENORPersonNm
Phone2702985495PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1
CityHARTFORDCity
StateKYState
ZIP Code42347ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JUANITA PARK
PRESIDENT2.00Yes (X)Yes (X)$0$0$0
JANE CANARY
VICE PRESIDENT2.00Yes (X)Yes (X)$0$0$0
JONATHAN SHREWSBURY OD
SECRETARY/TREASURER2.00Yes (X)Yes (X)$0$0$0
JIM DUKE
DIRECTOR2.00Yes (X)$0$0$0
KELLY ROE
DIRECTOR2.00Yes (X)$0$0$0
CARLA WALLACE
DIRECTOR2.00Yes (X)$0$0$0
GERALD WESTERFIELD
DIRECTOR2.00Yes (X)$0$0$0
LLOYD SPIVEY
DIRECTOR2.00Yes (X)$0$0$0
JOSHUA SKIBBA
CARDIOLOGIST/MEDICAL REPRESENTATIVE40.00Yes (X)$380,402$0$47,149
JANNA PATHI
CMO/SURGEON40.00Yes (X)$317,975$0$60,868
ATHENA MINOR
CHIEF NURSING OFFICER40.00Yes (X)$52,954$0$18,850
MUKESH DESAI
UROLOGIST40.00$556,545$0$61,923Yes (X)
CHARLES RICCIO
GASTROENTEROLOGIST40.00$506,437$0$63,224Yes (X)
JOEL JOHNSTON
PHYSICIAN ER40.00$323,557$0$28,930Yes (X)
STEVEN MILLS
PHYSICIAN40.00$316,188$0$27,952Yes (X)
HEATHER GARRETT
PHYSICIAN40.00$287,362$0$22,676Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,741,420TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$331,572TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
EMCARE PHYSICIAN SERVICES
105 CONTINENTAL PLACEBRENTWOODTN37027ER PHYSICIANS$522,799
QUOROM HEALTH RESOURCES
7032 COLLECTION CENTER PLACECHICAGOIL60693MANAGEMENT FEES$264,880
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$22,564AllOtherContributionsAmt
Total Contributions$22,564TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICESDesc
Business621300BusinessCd
Total Revenue Column$32,549,981TotalRevenueColumnAmt
Related Or Exempt Func Income$32,549,981RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$32,549,981TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,605TotalRevenueColumnAmt
Exclusion$8,605ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$48,877RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$48,877RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,877TotalRevenueColumnAmt
Exclusion$48,877ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$16,191OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$16,191OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,191TotalRevenueColumnAmt
Exclusion-$16,191ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PHARMACY SALES446110$1,743,502$1,743,502
MISCELLANEOUS INCOME621300$394,775$394,775
CAFETERIA INCOME722210$61,596$61,596

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,439TotalRevenueColumnAmt
Related Or Exempt Func Income$56,439RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,256,312OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,870,148TotalRevenueColumnAmt
Related Or Exempt Func Income$34,806,293RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$41,291ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,121,115TotalAmt
Program Services$1,121,115ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,455,860TotalAmt
Program Services$14,502,171ProgramServicesAmt
Management And General$953,689ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$197,877TotalAmt
Program Services$180,356ProgramServicesAmt
Management And General$17,521ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,883,851TotalAmt
Program Services$1,772,971ProgramServicesAmt
Management And General$110,880ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,085,916TotalAmt
Program Services$1,022,933ProgramServicesAmt
Management And General$62,983ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$264,880TotalAmt
Management And General$264,880ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$79,994TotalAmt
Program Services$9,628ProgramServicesAmt
Management And General$70,366ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$60,000TotalAmt
Management And General$60,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,569,139TotalAmt
Program Services$1,889,236ProgramServicesAmt
Management And General$679,903ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$85,191TotalAmt
Program Services$85,191ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$147,826TotalAmt
Program Services$94,369ProgramServicesAmt
Management And General$53,457ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,160,257TotalAmt
Program Services$1,785,865ProgramServicesAmt
Management And General$374,392ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$166,304TotalAmt
Program Services$131,539ProgramServicesAmt
Management And General$34,765ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$195,068TotalAmt
Program Services$195,068ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$997,037TotalAmt
Program Services$997,037ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$433,859TotalAmt
Program Services$15,214ProgramServicesAmt
Management And General$418,645ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES AND DR$5,099,564$5,099,564
BAD DEBT$2,094,450$2,094,450
TAXES AND LICENSES$474,923$474,923
OTHER SUPPLIES$279,183$215,919$63,264

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$363,020TotalAmt
Program Services$273,723ProgramServicesAmt
Management And General$89,297ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$35,215,314TotalAmt
Program Services$31,486,349ProgramServicesAmt
Management And General$3,728,965ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,603,474BOYAmt
EOY$707,218EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,073,592BOYAmt
EOY$1,042,245EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,699,005BOYAmt
EOY$5,353,877EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$817,332BOYAmt
EOY$839,936EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$882,180BOYAmt
EOY$879,672EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$162,984BOYAmt
EOY$163,426EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$24,962,809LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$17,257,439LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,930,670BOYAmt
EOY$7,705,370EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$395,709BOYAmt
EOY$983,772EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,564,946BOYAmt
EOY$17,675,516EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,448,095BOYAmt
EOY$2,952,721EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$356,535BOYAmt
EOY$374,285EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,280,000BOYAmt
EOY$3,660,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$615,668BOYAmt
EOY$1,329,576EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,610,700BOYAmt
EOY$450,152EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,310,998BOYAmt
EOY$8,766,734EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,253,948BOYAmt
EOY$8,908,782EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,253,948BOYAmt
EOY$8,908,782EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,564,946BOYAmt
EOY$17,675,516EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$345,166ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,713OtherActivitiesAmt
Total Lobbying Expenditures$2,713TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL PAYS DUES TO THE KENTUCKY HOSPITAL ASSSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$530,032OtherCostOrOtherBasisAmt
Book Value$530,032BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,358,602OtherCostOrOtherBasisAmt
Depreciation$4,141,160DepreciationAmt
Book Value$4,217,442BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,581,602OtherCostOrOtherBasisAmt
Depreciation$12,767,454DepreciationAmt
Book Value$2,814,148BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$492,573OtherCostOrOtherBasisAmt
Depreciation$348,825DepreciationAmt
Book Value$143,748BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,705,370TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
NET BOND ISSUE COSTS$61,101
RETIREMENT BENEFITS$298,134
OTHER NONCURRENT ASSETS$137,516
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$487,021
FieldValueIRS element (for citing)
Total Book Value Other Assets$983,772TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
THIRD PARTY SETTLEMENTS$152,018
RETIREMENT BENEFITS$298,134
FieldValueIRS element (for citing)
Total Liability$450,152TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$34,870,148TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$34,870,148RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$34,870,148TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$35,215,314TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$35,215,314ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$35,215,314TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740-10 "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES" WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS WITHIN THE FINANCIAL STATEMENTS. THE HOSPITAL MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2014 AND 2013. AS OF SEPTEMBER 30, 2014 AND 2013, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTIONS. WITH A FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2011.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$796,446TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$484,674DirectOffsettingRevenueAmt
Net Community Benefit Expns$311,772NetCommunityBenefitExpnsAmt
Total Expense0.00940TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,174,450TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,253,343DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,921,107NetCommunityBenefitExpnsAmt
Total Expense0.05800TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,970,896TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,738,017DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,232,879NetCommunityBenefitExpnsAmt
Total Expense0.06740TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$51,071TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$51,071NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$51,071TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$51,071NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,021,967TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,738,017DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,283,950NetCommunityBenefitExpnsAmt
Total Expense0.06890TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,055,325BadDebtExpenseAmt
Bad Debt Expense Attributable$342,517BadDebtExpenseAttributableAmt
Reimbursed By Medicare$8,000,731ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,033,115CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$32,384MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OHIO COUNTY HOSPITAL CORPORATIONBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11211 OLD MAIN STREETAddressLine1
CityHARTFORDCity
StateKYState
ZIP Code42347ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1OHIO HOSPITAL CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care0FPGUsedDetermEligDscntCareInd
Explained BasisYes (1)ExplainedBasisInd
State RegulationYes (X)StateRegulationInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Other ActionsYes (X)PermitOtherActionsInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
OHIO HOSPITAL CORPORATIONPART V, SECTION B, LINE 3: GREEN RIVER DISTRICT HEALTH DEPARTMENT (GRDHD) PARTNERED WITH UNIVERSITY OF KENTUCKY'S APPALACHIA PUBLIC HEALTH TRAINING CENTER TO PERFORM COMMUNITY HEALTH NEED ASSESSMENTS IN OHIO COUNTY USING THE MAPP PROCESS. THE MAPP PROCESS INCLUDED IDENTIFYING COMMUNITY PARTNERS. A COMPLETED SEARCH OF EXISTING HEALTHCARE RELATED INFORMATION AND DATA FROM PUBLIC INFORMATION SOURCES. PARTNERS MET IN AN INITIAL PUBLIC HEALTH FORUM DESIGNED TO REVIEW KEY HEALTH RELATED STATISTICS AND ANALYSIS FOR THE COUNTY, COMPLETED A PAPER SURVEY THAT WAS DISTRIBUTED IN LOCAL HEALTH DEPARTMENT CLINICS AND HAD AN ONLINE SURVEY, HELD A SECOND MEETING OF COMMUNITY PARTNERS TO EVALUATE ANALYSIS PREVIOUSLY COMPLETED AND CONSIDER RESULTS OF SURVEYS.
OHIO HOSPITAL CORPORATIONPART V, SECTION B, LINE 10: OHIO COUNTY HOSPITAL PROVIDES SERVICES WITHOUT CHARGE TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY.ADMITTING CLERKS PROVIDE EACH UNINSURED PATIENT A CHARITY CARE APPLICATION AND ENCOURAGE HIM OR HER TO COMPLETE IT. THE APPLICATION CONTAINS DEMOGRAPHIC AND FINANCIAL INFORMATION USED IN DETERMINING IF SOMEONE IS ELIGIBLE FOR CHARITY CARE. ALL COMPLETED APPLICATIONS ARE FORWARDED TO DISABILITY & MEDICAL CONSULTANTS, INC. (DMC). DMC USES THE INFORMATION ON THE APPLICATION TO DETERMINE IF THE PATIENT MEETS THE STATE CRITERIA FOR CHARITY CARE.IT MUST BE DOCUMENTED THAT THE PATIENT:1.HAS NO CURRENT VALID INSURANCE COVERAGE AND IS NOT ELIGIBLE TO APPLY FOR PUBLIC ASSISTANCE OR OTHER INSURANCE. PERSONS WITH EXHAUSTED MEDICARE AND MEDICAID BENEFITS WOULD BE CONSIDERED WITHOUT VALID INSURANCE, UNLESS THEY ARE ELIGIBLE TO APPLY FOR ADDITIONAL DAYS. 2.THE PATIENT MUST MEET THE CRITERIA ESTABLISHED BY THE STATE TO QUALIFY FOR THE CHARITY CARE PROGRAM. THE STATE REQUIRES THAT FINANCIAL PROOF FOR CHARITY (SUCH AS TAX RETURNS, PAY STUBS, ECT.) BE PROVIDED FOR ALL INPATIENT PROCEDURES AND MAJOR OUTPATIENT PROCEDURES, WITH "MAJOR" BEING DEFINED BY THE HOSPITAL. OHIO COUNTY HOSPITAL DESIGNATES THAT OUTPATIENT SURGERIES BE CONSIDERED MAJOR AND WILL REQUIRE PROOF FOR THE SAME.THOSE ACCOUNTS MEETING STATE INDIGENT CARE GUIDELINES, AS DETERMINED BY DMC, WILL BE SO DESIGNATED IN THE COMPUTER SYSTEM. A COLLECTIONS REPORT WILL BE GENERATED AND FORWARDED TO DATA PROCESSING FOR ACCOUNT WRITE-OFF. THE CONTROLLER PERFORMS A MONTHLY REVIEW OF CHARITY CARE WRITE-OFFS FOR REASONABLENESS. THE DOCUMENTATION AND CHARITY LIST IS FORWARDED TO THE BUSINESS OFFICE MANAGER, WHO WILL PREPARE OR DESIGNATE SOMEONE TO PREPARE, THE REPORT TO BE SENT TO THE STATE.
OHIO HOSPITAL CORPORATIONPART V, SECTION B, LINE 16E: THE ONLY FINANCIAL AID PROGRAM IS WHAT THE STATE OFFERS AS THE "DSH" PROGRAM. THE HOSPITAL USE AND OUTSIDE COMPANY-DMC WHO DETERMINES IF ALL OF THE PRIVATE PAY PATIENTS FIRST ARE ELIGIBLE FOR MEDICAID AND IF THEY ARE NOT THEY DETERMINE IF THEY ARE ELIGIBLE FOR THE STATE INDIGENT PROGRAM. IF THEY ARE ELIGIBLE FOR THE STATE PROGRAM THE ENTIRE BALANCE IS WRITTEN OFF. THE HOSPITAL DOES NOT HAVE ANY KIND OF OTHER FAP OR SEPARATE CHARITY CARE POLICY. IF THE PRIVATE PAY PATIENTS ARE ELIGIBLE FOR EITHER OF THE TWO PROGRAMS, THE HOSPITAL HAVE BEGAN OFFERING (OCTOBER 2011), A PRIVATE PAY DISCOUNT WHICH INITIALLY DISCOUNTS 40% OFF THE PATIENT'S ACCOUNT BALANCE. ALL OF THE PRIVATE PAY PATIENTS RECEIVE 3 STATEMENTS, 2 LETTERS AND SOMETIMES A OTHER LETTER BEFORE BEING SENT TO OUR COLLECTIONS AGENCY. THE COLLECTION AGENCY THEN DETERMINES THE ABILITY TO PAY AND THEY TAKE ACTIONS BASED ON THE RESULTS OF THEIR FINDINGS.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,094,450.
PART II, COMMUNITY BUILDING ACTIVITIES:OHIO COUNTY HOSPITAL USED THE INFORMATION COLLECTED FROM THE MAPPS SURVEY PROCESS TO DETERMINE WHICH HEALTH NEEDS COULD BE IMPACTED BY COLLABORATION BETWEEN OUR FACILITY AND THE OHIO COUNTY HEALTH COALITION. THESE KEY HEALTH-CARE ISSUES WERE ALIGNED WITH THE MISSION AND PRIORITIES OF OHIO COUNTY HOSPITAL AND WERE INCORPORATED INTOTHE 2013 STRATEGIC PLAN. IT WAS DETERMINED THAT OHIO COUNTY HOSPITAL HAD THE RESOURCES AND ABILITY TO IMPACT EACH OF THE THREE KEY AREAS OF FOCUS:IMPROVE COMMUNITY LIFESTYLE CHOICESOHIO COUNTY HOSPITAL IS THE LEADER IN PROMOTING HEALTH AND WELLNESS IN THE COMMUNITY. THE HOSPITAL PROVIDES FINANCIAL SPONSORSHIP, AS WELL AS COORDINATES AND PROVIDES EMPLOYEE VOLUNTEERS, FOR THE MAJORITY OF THE HEALTH OUTREACH INITIATIVES IN OHIO COUNTY. EXAMPLES OF THESE PROGRAMS INCLUDE: RELAY FOR LIFE, GO RED HEART EDUCATION LUNCH & LEARN, SENIOR HEALTH FAIR, COMMUNITY-WIDE HEALTH FAIR, HEALTHY EATING FOOD DEMONSTRATIONS HOSTED AT LOCAL GROCERY STORES, BREAST CANCER AWARENESS EVENTS, GRIEF SUPPORT GROUP THROUGH HOSPICE, GO BLUE PROSTRATE CANCER EDUCATION EVENTS, ANNUAL OCH FALL INTO FITNESS 5K AND OCH SUMMER SIZZLE 5K. OHIO COUNTY HOSPITAL ALSO PROVIDES MEETING SPACE FOR RETIRED TEACHERS ASSOCIATION,FREE SMOKING CESSATION PROGRAM, HOSPITAL EMPLOYEE UNITED WAY FUND-DRIVE, HABITAT FOR HUMANITY FALL FESTIVAL, AND HEALTH STUDENTS CAREER DAY. HOSPITAL STAFF PARTICIPATES IN THE COMMUNITY SCHOOL SYSTEM BACK TO SCHOOL BASHES TO DISTRIBUTE INFORMATION ON CHILDHOOD IMMUNIZATIONS AND WELL-CHILD VISITS. ADDITIONALLY,HOSPITAL STAFF ARE VOLUNTEERS IN THE 4-H BODY WALK AN INTERACTIVE DISPLAY TO TEACH MIDDLE SCHOOL STUDENTS ABOUT THE HUMAN BODY; OHIO COUNTY HOSPITAL ALSO PROVIDES OVER 100 HEALTHY MEALS TO THE VOLUNTEERS WHO WORK AT THE BODYWALK EVENT.CELEBRATE THE CHILD AN EVENT THAT DRAWS THOUSANDS OF COMMUNITY MEMBERS ANNUALLY AND FOCUS ON COMMUNITY ASSET BUILDING, AS WELL AS SAFETY AND HEALTH ISSUES. OCHS DIRECTOR OF COMMUNITY RELATIONS IS ACTIVE ON THE EVENT PLANNING COMMITTEE. OHIO COUNTY HOSPITAL SUBSIDIZES THE ADVERTISEMENT AND SUPPLIES FOR THE EVENT. IN ADDITION, SEVERAL STAFF PARTICIPATE IN A HOSPITAL BOOTH WHICH FOCUS ON CHILDREN MAKING HEALTHY FOOD AND EXERCISE CHOICES.LONGEST DAY OF PLAY - AN ANNUAL SUMMER EVENT WHERE FAMILIES CAN PARTICIPATE IN OVER 30 OUTDOOR PHYSICAL ACTIVITIES AT THE OHIO COUNTY PARK. IN 2013, OVER 1500 COMMUNITY MEMBERS AND VOLUNTEERS ATTENDED THE EVENT. HOSPITAL EMPLOYEES AND MEMBERS OF THE MEDICAL STAFF MAKE UP 25% OF THE VOLUNTEERS AT LONGEST DAY OF PLAY. THE HOSPITAL SUBSIDIZES THE ADVERTISEMENT AND SUPPLIES FOR THE EVENT, AS WELL PROVIDES FOOD FOR THE FREE HEALTHY PICNIC LUNCH.NEW YEARS NOON DANCE A FREE COMMUNITY DANCE PARTY HELD FOR FAMILIES AT NOON ON NEW YEARS EVE. THE EVENT WAS HELD AT THE OHIO COUNTY FAMILY WELLNESS CENTER. OHIO COUNTY HOSPITAL COORDINATED THE EVENT, PAID FOR ALL SUPPLIES, ADVERTISING, DJ SERVICES AND HEALTHY SNACKS. FAMILIES WERE PROVIDED INFORMATION ABOUT HEALTHY FOOD CHOICES AND THE BENEFITS OF EXERCISE.OHIO COUNTY HEALTH COALITION - A GROUP OF HEALTH-CARE FACILITIES, CIVIC GROUPS, INDUSTRY LEADERS AND COMMUNITY MEMBERS THAT MEET ON A MONTHLY BASIS REGARDING LOCAL HEALTH CARE ISSUES. OHIO COUNTY HEALTH COALITION IS A PART OF A REGIONAL HEALTH COALITION UNDER THE DIRECTION OF GREEN RIVER AREA DEVELOPMENT DISTRICT (GRADD). OHIO COUNTY HOSPITAL PROVIDES A FINANCIAL CONTRIBUTION TO GRADD TO HELP OFFSET THE EXPENSES OF THE HEALTH COALITIONS. MRS. ROBINSON, DIRECTOR OF COMMUNITY RELATIONS WITH OCH, SERVES AS CHAIR FOR EXECUTIVE COMMITTEE AND REPRESENTS OHIO COUNTY ON BOTH A LOCAL AND REGIONAL LEVEL. SEVERAL HOSPITAL EMPLOYEES ARE PART OF THE MEMBERSHIP BODY AND OCH PROVIDES THE MEAL AT EACH MEETING, AS WELL AS, THE MONTHLY MEAL FOR THE MCLEAN COUNTY HEALTH COALITION. MCLEAN COUNTY IS A NEIGHBORING COUNTY THAT DOES NOT HAVE A HOSPITAL IN ITS COMMUNITY. OHIO COUNTY HOSPITAL WILL CONTINUE TO ACTIVELY PARTICIPATE IN PROGRAMS AND EFFORTS SPONSOREDBY GRADD HEALTH COUNCIL AND OHIO COUNTY HEALTH COALITION TO IMPROVE THE HEALTH OF THE COMMUNITY.INCREASE ACCESS TO HEALTHCAREOHIO COUNTY HOSPITAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.OCH WILL CONTINUE TO COOPERATE AND WORK WITH ALL MEDICAID MANAGED CARE PROVIDERS TO IMPROVE SERVICES FOR COVERED INDIVIDUALS.OCH WILL REVIEW AND UPDATE ITS CHARITY CARE POLICY TO PROVIDE EXPANDED FINANCIAL ASSISTANCE TO PATIENTS WHO ARE UNABLE TO QUALIFY FOR INSURANCE.DURING THE 2013 FISCAL YEAR, OCH RECRUITED ONE FAMILY MEDICINE PHYSICIAN AND TWO ADDITIONAL FAMILY MEDICINE NURSE PRACTITIONERS.OCH WILL FURTHER EXPAND QUICK CARE SERVICES WHICH PROVIDE A LOWER-COST ALTERNATIVE TO NON-EMERGENCY ER VISITS. STAFF OF PRIMARY CARE OFFICES WILL IDENTIFY REPEAT QUICK CARE PATIENTS WITH CHRONIC ILLNESSES, WHO DO NOT HAVE AN ESTABLISHED MEDICAL HOME, AND HELP TO FACILITATE AN APPOINTMENT WITH AN OHIO COUNTY FAMILY CARE PROVIDER.OCH WILL CONTINUE TO DEVELOP THE HOSPITALS HEALTH IMPROVEMENT PROGRAM, BENEFITING UNINSURED AND/OR UNDER-INSURED MEMBERS OF OUR COMMUNITY. THIS PROGRAM OFFERS ACCESS TO PRIMARY CARE SERVICES, PREVENTIVE SCREENINGS, NUTRITIONAL AND PHYSICAL ACTIVITY COUNSELING, SMOKING CESSATION ASSISTANCE, AS WELL AS SUBSIDIZED MEMBERSHIPS INTO A LOCAL FITNESS FACILITIES. PROGRAM ELIGIBILITY IS BASED ON THE FEDERAL POVERTY LEVEL GUIDELINES. THE COST OF THE SERVICES THAT PARTICIPANTS RECEIVE IS SUBSIDIZED BY OHIO COUNTY HOSPITAL.REDUCE SUBSTANCE ABUSEOCH WILL PROVIDE THE MEETING PLACE, TRAINED FACILITATORS, AND SUPPLIES FOR COOPER-CLAYTON SMOKING CESSATION COURSE OFFERED FREE TO COMMUNITY, AND WILL OFFER THESE AT LEAST TWICE PER YEAR.OCH WILL WORK IN CONJUNCTION WITH COMMUNITY PARTNERS TO SEEK IMPLEMENTATION OF SMOKE FREE PUBLIC ENVIRONMENTS THROUGHOUT THE COMMUNITY. THIS WILL INCLUDE FACILITATING DIALOGUE WITH LOCAL AND STATE LEVEL OFFICIALS REGARDING THE HEALTH BENEFITS OF ADOPTING A COMMUNITY-WIDE SMOKE FREE ORDINANCE.OCH AND ASSOCIATED PROVIDER OFFICES WILL FOLLOW A CONTROLLED SUBSTANCE PRESCRIPTION POLICY WHICH INCLUDES ROUTINE DRUG TESTING TO ASSURE PROPER UTILIZATION OF NARCOTIC SUBSTANCES.OCH WILL FULLY UTILIZE THE STATE KASPER REPORT SYSTEM TO ASSIST IN MONITORING CONTROLLED SUBSTANCE PRESCRIPTION DRUG USE BY PATIENTS.OCH STAFF WILL PROVIDE INSTRUCTIONS REGARDING PRESCRIBED MEDICATIONS AND THEIR PROPER USE FOR ALL PATIENTS UPON DISCHARGE FROM THE HOSPITAL.OHIO COUNTY HOSPITAL WILL ALSO CONTINUE TO SUPPORT THE OHIO COUNTY HEALTH COALITIONS AND LOCAL CIVIC GROUP "TOGETHER WE CARE" EFFORTS IN THIS AREA BY PROVIDING LEADERSHIP OVERSIGHT, MONETARY SUPPORT AND ATTENDANCE AT MONTHLY MEETINGS BY VARIOUS HOSPITAL PERSONNEL.SPECIFICALLY IN REGARDS TO PRESCRIPTION ABUSE / MISUSE.
PART III, LINE 4:LINE 2 PART III EXPLANATION FOR HOW BAD DEBT IS CALCULATED IS PROVIDED IN THE FOOTNOTE OF THE FINANICIALS.ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT THE HOSPITAL EXPECTS TO COLLECT. THE HOSPITAL MAINTAINS ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE INABILITY OF ITS PATIENTS TO MAKE REQUIRED PAYMENTS. MANAGEMENT CONSIDERS THE FOLLOWING FACTORS WHEN DETERMINING THE COLLECTABILITY OF PATIENT ACCOUNTS: PAYOR CREDIT-WORTHINESS, PAST TRANSACTION HISTORY WITH THE PAYOR, CURRENT ECONOMIC INDUSTRY TRENDS, AND CHANGES IN PAYOR PAYMENT TERMS. IF THE FINANCIAL CONDITION OF THE HOSPITAL'S PAYORS OR PATIENTS WERE TO DETERIORATE, ADVERSELY AFFECTING THEIR ABILITY TO MAKE PAYMENTS, ADDITIONAL ALLOWANCES WOULD BE REQUIRED. BASED ON MANAGEMENT'S ASSESSMENT, THE HOSPITAL PROVIDES FOR ESTIMATED UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO EARNINGS AND A CREDIT TO ALLOWANCE. BALANCES THAT REMAIN OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.
PART III, LINE 8:THE METHODOLOGY USED TO DETERMINE THE AMOUNT IN BOX 51 WAS THE COST TO CHARGE RATIO.
PART III, LINE 9B:ALL ACCOUNTS MOVE THROUGH THE REGISTRATION, MEDICAL CODING AND INSURANCE BILLING PROCESS. IF THE PATIENT HAS AN INSURANCE OR GOVERNMENT PLAN THAT PAYER WILL BE BILLED. ONCE THEY PAY, THE ACCOUNT IS REVIEWED FOR CORRECT BALANCE. THEN CPSI ASSIGNS A CYCLE CODE TO EACH ACCOUNT WHICH DRIVES WHEN A STATEMENT WILL BE ISSUED. THE STATEMENTS THEN FOLLOW IN 28 DAY CYCLES. EACH PATIENT SHOULD RECEIVE AT LEAST 3 STATEMENTS AND 2 LETTERS. WITH THIS CYCLE EVERY PATIENT WILL RECEIVE STATEMENTS FOR GREATER THAN 120 DAY PERIOD. IN THE EVENT THAT THE PATIENT MAKES ANY PAYMENT AT ALL, THE STATEMENT CYCLE IS SET BACK TO THE BEGINNING.A PATIENT WITH NO INSURANCE GOES THROUGH REGISTRATION, A REVIEW FOR ANY POSSIBLE PAYER AND KENTUCKY DSH PROGRAM. ONCE IT HAS BEEN DETERMINED THAT THERE IS NO OTHER PAYER SOURCE, THE DSH APPLICATIONS ARE SENT TO DMS CONSULTANTS FOR REVIEW OF POTENTIAL MEDICAID OR DSH APPROVAL. DMC NOTIFIES OHIO COUNTY HOSPITAL IF THE PATIENT HAS EITHER INSURANCE, MEDICAID OR HAS BEEN APPROVED FOR THE DSH PROGRAM. ADJUSTMENTS ARE MADE ACCORDINGLY FROM THESE FINDINGS. IF NO INSURANCE AND NOT QUALIFIED FOR ANY PROGRAMS A DENIAL IS SENT TO THE PATIENT.THE PRIVATE PAY PATIENTS ARE ALSO RECEIVING THE SAME BILLING CYCLE AS ALL OTHER PAYERS. DURING THIS CYCLE WE ALSO RECEIVE INCOMING CALLS AND PATIENT WALK IN'S, AS WELL AS MAKING PHONE CALLS AS TIME PERMITS FOR ADDITIONAL ATTEMPTS TO COLLECT.ALL ACCOUNTS ARE DOCUMENTS AS STATEMENTS, LETTERS AND PHONE CALL ATTEMPTS ARE MADE AT THE ATTEMPT TO COLLECT THE BALANCE OF THE ACCOUNT.IN THE EVENT THAT OHIO COUNTY HOSPITAL STAFF HAS BEEN UNABLE TO COLLECT THE OUTSTANDING DEBT, ACCOUNTS ARE TURNED OVER TO AN OUTSIDE COLLECTION AGENCY. THE AGENCY THEN FOLLOWS AS DIRECTED BY OCH TO ATTEMPT FOR AN ADDITIONAL 120 DAYS OR NO PAYMENT WITHIN THE LAST 12 MONTHS. THEIR ATTEMPTS ALSO INCLUDES LETTERS, PHONE CALLS AND PLACED ON CREDIT REPORTING SYSTEMS.IN THE EVENT THAT THE COLLECTION AGENCY HAS BEEN UNSUCCESSFUL AT THE COLLECTION, THE ACCOUNTS WILL BE DEEMED UNCOLLECTIBLE, CLOSED AND RETURNED FROM CREDIT REPORTING AND THEN CANCELED BACK TO HOSPITAL. HOSPITAL STAFF THEN PLACES A NOTE ON THAT ACCOUNT THAT IT HAS BEEN DEEMED UNCOLLECTIBLE. HOSPITAL OR COLLECTION AGENCY MAKES NO FURTHER ATTEMPTS AT COLLECTION AT THIS POINT.HOSPITAL COMPILES A REPORT FOR THE UNCOLLECTIBLE DEDUCTIBLE AND CO INSURANCE THAT HAVE BEEN DEEMED IN THE SAME COST REPORTING FISCAL YEAR PERIOD. THIS REPORT IS PROVIDED TO CMS WHEN EVER NECESSARY. MOST COMMONLY ATTACHED TO THE COST REPORT.
PART VI, LINE 2:IN DECEMBER 2012, OHIO COUNTY HOSPITAL, IN CONJUNCTION WITH THE OHIO COUNTY HEALTH COALITION, GREEN RIVER DISTRICT HEALTH DEPARTMENT AND OTHER KEY COMMUNITY STAKEHOLDERS, CONDUCTED A PLANNING RETREAT TO REVIEW THE GREEN RIVER COMMUNITY HEALTH ASSESSMENT HEALTH IMPROVEMENT PLAN. THIS DOCUMENT IS A COMPREHENSIVE COLLECTION AND ANALYSIS OF DATA REGARDING HEALTH ISSUES AND NEEDS BROKEN DOWN BY COUNTY FOR GREEN RIVER DEVELOPMENT DISTRICT (GRADD). THE INFORMATION FOR THE REPORT WAS OBTAINED BY UTILIZATION OF A COMMUNITY HEALTH ASSESSMENT PROCESS BASED ON MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP).IN OHIO COUNTY, THE MAPP PROCESS INCLUDED THE FOLLOWING KEY STEPS: COMMUNITY PARTNERS WERE IDENTIFIED FROM THE OHIO COUNTY HEALTH COALITION, OTHER HEALTH CARE AGENCIES, LOCAL GOVERNMENT, SCHOOLS, BUSINESSES, CIVIC ORGANIZATIONS, AND VOLUNTEERS FROM THE GENERAL PUBLIC.COMPLETED A SEARCH OF EXISTING HEALTH CARE-RELATED INFORMATION AND DATA FROM PUBLIC INFORMATION SOURCES;THE PARTNERS MET IN AN INITIAL PUBLIC HEALTH FORUM DESIGNED TO REVIEW KEY HEALTH-RELATED STATISTICS FOR THE COUNTY AND TO COMPLETE A STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS (SWOT) ANALYSIS FOR THE COUNTY;COMPLETED A PAPER SURVEY, DISTRIBUTED IN LOCAL HEALTH DEPARTMENT CLINICS, AND AN ON-LINE SURVEY, TO OBTAIN WIDER INPUT FROM INDIVIDUALS INTO THE COMMUNITYS HEALTH NEEDS.HELD A SECOND MEETING OF COMMUNITY PARTNERS TO EVALUATE THE SWOT ANALYSIS PREVIOUSLY COMPLETED AND TO CONSIDER RESULTS FROM THE COMPLETED SURVEYS. THIS FORUM WORKED TO IDENTIFY AND GROUP SIMILAR HEALTH RELATED CONCERNS FOR THE COUNTY AS FOLLOWS: 1) IMPROVE COMMUNITY LIFESTYLE CHOICES; 2) INCREASE HEALTH CARE ACCESS; AND3) REDUCE SUBSTANCE ABUSE. THE OHIO COUNTY HEALTH COALITION WAS DETERMINED TO BE THE ORGANIZATION WITH PRIME RESPONSIBILITY FOR ADDRESSING THESE STRATEGIC HEALTH CARE INITIATIVES ON AN ON-GOING BASIS.A GREEN RIVER COMMUNITY HEALTH ASSESSMENT HEALTH IMPROVEMENT PLAN WAS DEVELOPED FOR THE REGION AND EACH OF THE DISTRICTS COUNTIES. THIS PLAN WAS REVIEWED WITH THE OHIO COUNTY HEALTH COALITION AND OTHER COMMUNITY PARTNERS.OHIO COUNTY HOSPITAL USED THE INFORMATION COLLECTED FROM THE MAPPS SURVEY PROCESS TO DETERMINE WHICH HEALTH NEEDS COULD BE MOST IMPACTED BY COLLABORATION BETWEEN OUR FACILITY AND THE OHIO COUNTY HEALTH COALITION. IT WAS DETERMINED THAT THE OHIO COUNTY HOSPITAL HAD THE NECESSARY RESOURCES AND ABILITY TO IMPACT THE FOLLOWING HEALTH NEEDS: IMPROVING COMMUNITY LIFESTYLE CHOICES, INCREASE ACCESS TO HEALTHCARE, AND REDUCE SUBSTANCE ABUSE. THESE KEY HEALTHCARE ISSUES ALIGNED WITH THE MISSION AND PRIORITIES OF OHIO COUNTY HOSPITAL AND WERE INCORPORATED INTO THE2013 STRATEGIC PLAN.THE GREEN RIVER ASSESSMENT COMMUNITY PLAN AND OHIO COUNTY HOSPITALS STRATEGIC IMPLEMENTATION PLAN WERE ADOPTED BY BOARD RESOLUTION FROM OHIO COUNTY HOSPITALS TRUSTEES ON JUNE 13, 2013. THE HEALTH IMPROVEMENT PLAN WAS MADE WIDELY AVAILABLE TO THE COMMUNITY VIA THE HOSPITALS WEBSITE, AS WELL AS THROUGH HARD COPIES LOCATED AT THE HOSPITALS FRONT DESK.
PART VI, LINE 3:OHIO COUNTY HOSPITAL'S ADMITTING AND BUSINESS OFFICE STAFF PROVIDES CHARITY CARE APPLICATIONS TO ANY PATIENT THAT DOESN'T HAVE INSURANCE DURING THE REGISTRATION PROCESS. IF THE PATIENT DOESN'T COMPLETE THE APPLICATION AT THAT TIME, THEIR DEMOGRAPHIC INFORMATION IS THEN SENT TO AN OUTSIDE COMPANY, DMC, INC, AND THEY DETERMINE IF THE PATIENT IS ELIGIBLE FOR EITHER MEDICAID OR CHARITY CARE. DMC WILL FOLLOW-UP WITH THE PATIENT TO GET ADDITIONAL INFORMATION AS NEEDED. ONCE THE ACCOUNT IS BILLED AND IS IN THE COLLECTION PROCESS, OUR PRIVATE PAY COUNSELORS CHECK EACH ACCOUNT TO MAKE SURE THAT IT HAS BEEN CHECKED FOR INDIGENT CARE ELIGIBILITY.
PART VI, LINE 4:HISTORICALLY 90% OF ALL ADMISSIONS AND 95% OF ALL OUTPATIENT SERVICES PERFORMED AT OHIO COUNTY HOSPITAL ARE PROVIDED TO RESIDENTS OF OHIO COUNTY; 94% OF ALL MEDICARE INPATIENT ADMISSIONS ARE GENERATED FROM THE OHIO COUNTY AREA. THE HOSPITALS PRIMARY SERVICE AREA INCLUDES THE RESIDENTS OF THE INCORPORATED CITIES OF HARTFORD, BEAVER DAM, ROSINE, FORDSVILLE, HORSE BRANCH AND CROMWELL. OHIO COUNTY IS GEOGRAPHICALLY THE FIFTH LARGEST COUNTY IN KENTUCKY. TOTAL POPULATION AS OF 2013 WAS 23,988.THE PER CAPITA INCOME (MEAN INCOME FOR EVERY MAN, WOMAN, AND CHILD IN A PARTICULAR GROUP) HAS DECREASED FROM THE PREVIOUS YEAR TO $18,409.00 COMPARED TO THE KENTUCKY AVERAGE OF $23,210. OHIO COUNTY IS A DESIGNATED A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVICED AREA / POPULATION (MUA/P). IN 2013, THE PERCENTAGE OF OHIO COUNTYS POPULATION LIVING BELOW THE POVERTY LEVEL INCREASED TO 20.89%. ACCORDING TO KENTUCKY HEALTH FACTS, THE RATE FOR UNINSURED ADULTS (UNDER 65 YEARS) IS 22%, WHICH IS SECOND HIGHEST IN THE GRADD REGION, AND THE RATE FOR UNINSURED CHILDREN (UNDER 19 YEARS) IS 7%. STATISTICS ALSO REPORT THAT 20% OF ADULTS IN THE OHIO COUNTY EXPERIENCED A TIME IN THE PAST YEAR NEEDED TO SEE A DOCTOR BUT DID NOT BECAUSE OF THE COST.
PART VI, LINE 5:OHIO COUNTY HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS WHO ARE COMMITTED TO THE HEALTH AND WELFARE OF THE COMMUNITY AND DEDICATED TO ENSURING THE VIABILITY OF THE HOSPITAL FOR YEARS TO COME. THE BOARD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA. SURPLUS FUNDS PROVIDE FOR CONTINUITY OF HEALTHCARE SERVICES DURING PERIODS OF ECONOMIC DOWNTURN, RECRUITMENT OF ADDITIONAL PROVIDERS TO IMPROVE THE ACCESS TO HEALTHCARE, AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK AND SERVES ALL CITIZENS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDES REPRESENTATION AND SUPPORT TO THE OHIO COUNTY CHAMBER BOARD OF DIRECTORS, OHIO COUNTY TOURISM, OHIO COUNTY INDUSTRIAL FOUNDATION, AND LEADERSHIP OHIO COUNTY PROGRAM, WHICH ARE ORGANIZATIONS WORKING TOWARDS THE ECONOMIC GROWTH OF OUR AREA.
PART VI, LINE 7, REPORTS FILED WITH STATESKY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOSHUA SKIBBA
CARDIOLOGIST/MEDICAL REPRESENTATIVE$380,402$0$0$0$0$0$42,543$0$4,606$0$427,551$0$0$0
JANNA PATHI
CMO/SURGEON$317,975$0$0$0$0$0$56,355$0$4,513$0$378,843$0$0$0
MUKESH DESAI
UROLOGIST$556,545$0$0$0$0$0$54,446$0$7,477$0$618,468$0$0$0
CHARLES RICCIO
GASTROENTEROLOGIST$474,757$0$31,680$0$0$0$55,808$0$7,416$0$569,661$0$0$0
JOEL JOHNSTON
PHYSICIAN ER$323,557$0$0$0$0$0$20,625$0$8,305$0$352,487$0$0$0
STEVEN MILLS
PHYSICIAN$223,048$0$93,140$0$0$0$24,238$0$3,714$0$344,140$0$0$0
HEATHER GARRETT
PHYSICIAN$250,174$0$37,188$0$0$0$15,836$0$6,840$0$310,038$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
OHIO COUNTY PUBLIC FACILITIES CORPORATION
A6160008050006772922005-08-01$4,240,000HOSPITAL CONSTRUCTION000
OHIO COUNTY PUBLIC FACILITIES CORPORATION
B6160008052010-09-29$3,620,000MEDICAL OFFICE BUILDING CONSTRUCTION000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$500,000$424,000$74,8232006Yes (1)0Yes (1)Yes (1)
B$3,160,000$273,400$70,000201100Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000Yes (1)00
B0000Yes (1)00

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AYes (1)Yes (1)0000
BYes (1)Yes (1)0000

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (4 entries)

Loan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
DR DESAI
SIGNON BONUSYes (X)$145,737$48,5790Yes (1)Yes (1)
DR BRUCE DURHAM
SIGNON BONUSYes (X)$20,000$16,0000Yes (1)Yes (1)
DR CHRISTEL MIRANDA
SIGNON BONUSYes (X)$32,814$30,9910Yes (1)Yes (1)
DR GILBRT LUCENO
SIGNON BONUSYes (X)$32,814$30,9910Yes (1)Yes (1)
FieldValueIRS element (for citing)
Total Balance Due$126,561TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE HOSPITAL CONTRACTS WITH QUORUM HEALTH RESOURCES, INC (QHR)TO PROVIDE MANAGEMENT SERVICES UNDER AN AGREEMENT WHICH EXPIRES IN 2014. THE CONTRACT REQUIRED QHR TO SUPPLY A CHIEF EXECUTIVE OFFICER, JOHN TICHENOR AND A CHIEF FINANCIAL OFFICER, BLAIN PIEPER WHOSE SALARY AND BENEFITS COST ARE PASSED DIRECTLY THROUGH TO THE HOSPITAL. THE HOSPITAL'S EXPENSE FOR THE MANAGEMENT FEE TOTALED APPOXIMATELY $264,880 FOR THIS YEAR.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 IS PROVIDED TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF DIRECTORS ARE COVERED UNDER THIS POLICY AND ANY CONFLICTS ARE RESOLVED AT MONTHLY BOARD MEETINGS.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS RECEIVED A COMPENSATION REVIEW BY QHR AND THE GOVERNING BOARD.OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION RECEIVE ANNUAL REVIEWS BASED ON CURRENT MARKET DATA.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.