2013-04-09T11:21:45-05:00 2012-06-30 BKD LLP 400 E MAIN ST STE 200 PO BOX 1196 BOWLING GREEN KY 421021196 990 2011-07-01 620701119 LAUGHLIN MEMORIAL HOSPITAL INC % MARK COMPTON CFO LAUG 4237875000 1420 TUSCULUM BLVD GREENEVILLE TN 37745 CHARLES H WHITFIELD JR 4237875000 2013-04-09 true JESSICA FREEMAN 2707810111 2011 2016-02-25 16:41:14Z CHARLES H WHITFIELD JR 1420 TUSCULUM BLVD GREENEVILLE TN 37745 75238433 false X WWW.LAUGHLINMEMORIAL.ORG X 1966 TN IMPROVING THE HEALTH AND WELL BEING OF INDIVIDUALS, FAMILIES AND OUR COMMUNITY BASED ON IDENTIFIED NEEDS. DELIVERING EMERGENCY CARE WITHOUT REGARD TO PATIENTS' ABILITY TO PAY. 10 5 941 46 2238 1238 296052 208912 69677367 62129359 2527789 3090083 707350 2823932 73208558 68252286 0 0 0 0 36990061 39156269 0 0 374091 36196076 31816332 73186136 70972601 22422 -2720315 171199474 165655422 51310253 52860350 119889221 112795072 IMPROVING THE HEALTH AND WELL BEING OF INDIVIDUALS, FAMILIES AND OUR COMMUNITY BASED ON IDENTIFIED NEEDS. 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AMOUNTS TO THIRD PARTIES 672076 INTEREST RATE SWAP AGREEMENT 4723980 6130965 68252286 70972601 -2720315 -2290775 -2083058 -4373833 -7094148 66784221 -2290775 998967 -1291808 68076029 176257 176257 68252286 71795311 998967 998967 70796344 176257 176257 70972601 RECONCILIATION TO AUDIT REPORT - NET ASSETS SCH D, PART XI, LINE 8 ---------------------- OTHER CHANGES IN NET ASSETS: CHANGE IN INTEREST OF LAUGHLIN HEALTHCARE FDN 47,120 CHANGE IN VALUE OF INTEREST SWAP (2,130,178) ------------- (2,083,058) RECONCILIATION TO AUDIT REPORT - REVENUES SCH D, PART XII, LINE 2D ---------------------- RENTAL EXPENSES SHOWN NET OF REVENUE PER 990 998,967 RECONCILIATION TO AUDIT REPORT - EXPENSES SCH D, PART XIII, LINE 2D ---------------------- RENTAL EXPENSES SHOWN NET OF REVENUE PER 990 998,967 INCOME TAXES SCH D, PART X, LINE 2 ---------------------- THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. true true true X true X true true true false true false 1694662 1694662 0.02390 10923249 7729033 3194216 0.04500 262352 235819 26533 0.00040 12880263 7964852 4915411 0.06930 366848 53262 313586 0.00440 43780 43780 0.00060 323111 178251 144860 0.00200 14819 14819 0.00020 748558 231513 517045 0.00720 13628821 8196365 5432456 0.07650 294919 294919 0.00420 294919 294919 0.00420 true 4479942 2300000 21350181 17359994 3990187 X true true 1 1 LAUGHLIN MEMORIAL HOSPITAL

1420 TUSCULUM BLVD GREENEVILLE TN 37745

X X X LAUGHLIN MEMORIAL HOSPITAL 1 false true true 150. true 200. true X X X X X X X true true X X X true false X X X X true X false false 3 LAUGHLIN HEALTHCARE CENTER

801 E MCKEE GREENEVILLE TN 37743

NURSING HOME SNF/ICF/REHAB LAUGHLIN HOME HEALTH

1420 TUSCULUM BLVD GREENEVILLE TN 37745

HOME HEALTH AGENCY LAUGHLIN MEDICAL GROUP

1406 TUSCULUM BLVD GREENEVILLE TN 37745

PHYSICIAN PRACTICE BAD DEBT EXPENSE SCH H, PART III, LINE 4 ---------------------- THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS, BASED ON THE INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNTS. COST OF BAD DEBTS IS ESTIMATED BY APPLICATION OF A COST TO CHARGE RATIO. HOSPITAL MANAGEMENT ESTIMATES THAT 40% OF THE NET BAD DEBT AMOUNTS WOULD QUALIFY FOR CHARITY IF FAMILY MEMBERS WOULD GIVE COMPLETE INFORMATION TO FINANCIAL ASSISTANCE PERSONNEL OF THE HOSPITAL. MEDICARE SHORTFALL SCH H, PART III, LINE 8A ---------------------- THE TOTAL REPORTED SHORTFALL IS COMMUNITY BENEFIT. AMOUNT REPORTED ON LINE 6 WAS OBTAINED THROUGH EXAMINATION OF MEDICARE COST REPORT COMPONENTS FOR 6/30/12. COLLECTION PRACTICES SCH H, PART III, LINE 9B ---------------------- Patients known to qualify for financial assistance are sent a letter indicating they have been approved for free or discounted care. These adjustments are applied to patient accounts before the next billing cycle. NEEDS ASSESSMENT SCH H, PART VI, LINE 2 ---------------------- LAUGHLIN MEMORIAL HOSPITAL PARTICIPATES IN THE GREENE COUNTY HEALTH COUNCIL ALONG WITH NUMEROUS OTHER HEALTH-RELATED ORGANIZATIONS. A GREENE COUNTY COMMUNITY HEALTH ASSESSMENT IS PREPARED BASED ON THIS GROUP'S WORK AND COORDINATED THROUGH THE NORTHEAST TENNESSEE REGIONAL HEALTH OFFICE OF THE TENNESSEE DEPARTMENT OF HEALTH. THE ASSESSMENT INCLUDES TOP 10 CONCERNS AND WAYS IN WHICH THE COUNCIL ADDRESSES FUTURE HEALTH PLANNING. THE MANAGEMENT TEAM OF LAUGHLIN MEMORIAL HOSPITAL DETERMINES HOW BEST TO WORK AS AN ORGANIZATION OR IN CONJUCTION WITH OTHER COUNCIL MEMBERS ON SOLUTIONS TO IDENTIFIED NEEDS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCH H, PART VI, LINE 3 ---------------------- THE REGISTRATION STAFF DESCRIBE AND PROVIDE LITERATURE ABOUT FINANCIAL ASSISTANCE DURING THE PATIENT INTERVIEW PROCESS. A MEDICAID STATE ELIGIBILITY WORKER IS PROVIDED OFFICE SPACE WITHIN THE HOSPITAL AND EFFORTS ARE MADE TO PUT PATIENTS IN CONTACT WITH THIS RESOURCE. APPLICATIONS FOR HOSPITAL CHARITY CARE ARE DISTRIBUTED BOTH BY THE REGISTRARS AND BILLING OFFICE STAFF. POSTED NOTICES AND THE HOSPITAL WEB SITE ARE OTHER SOURCES OF INFORMATION. COMMUNITY INFORMATION SCH H, PART VI, LINE 4 ---------------------- GREENE COUNTY, TN HAD A 2012 POPULATION OF 68,819 CITIZENS. THE HOSPITAL SERVES PRIMARILY GREENE COUNTY AND PATIENTS CLOSE TO THE BORDER OF GREENE COUNTY. THE MEDIAN HOUSEHOLD INCOME IN 2012 WAS $36,310 WITH AN ESTIMATED 21.6% OF THE COUNTY'S POPULATION LIVING IN POVERTY. THE COUNTY COVERS 621 SQUARE MILES. PROMOTION OF COMMUNITY HEALTH SCH H, PART VI, LINE 5 ---------------------- THE HOSPITAL PROVIDES REPRESENTATIVES AND SUPPORT FOR THE GREENE COUNTY PARTNERSHIP WHICH WORKS TOWARD ECONOMIC GROWTH OF THE AREA. LOCAL SCHOOLS ARE SUPPORTED THROUGH THE PARTNERS IN EDUCATION PROGRAM. THE GREENE COUNTY HEALTH COUNCIL IS HOSTED BY THE HOSPITAL. THE MEDICAL STAFF IS OPEN TO ANY PHYSICIAN WHO MEETS CREDENTIALING STANDARDS AND AGREES TO STANDARDS ESTABLISHED BY THE MEDICAL STAFF. VARIOUS BUSINESS LEADERS SERVE ON THE BOARD OF DIRECTORS ALONG WITH LEADERS OF THE PHYSICIAN COMMUNITY. SURPLUS FUNDS PROVIDE FOR CONTINUITY OF HEALTHCARE SERVICES DURING PERIODS OF ECONOMIC DOWNTURN AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. CHARGES FOR MEDICAL CARE SCH H, PART V, LINE 19 ---------------------- RATIO FROM LATEST STATE OF TENNESSEE JOINT ANNUAL REPORT REFLECTING AVERAGE COMMERCIAL INSURANCE REIMBURSEMENT. X X X X false true false false false false false false false CHARLES H WHITFIELD JR 299428 0 3120 0 1100 0 54138 0 15546 0 373332 0 0 0 JOHN MARK COMPTON 175201 0 1858 0 442 0 30492 0 10620 0 218613 0 0 0 RICK EALY 150345 0 1450 0 766 0 7693 0 7028 0 167282 0 0 0 ROBERT R ROARK 134494 0 0 0 0 0 22797 0 11844 0 169135 0 0 0 GREG JOHNSON 128496 0 0 0 0 0 6691 0 15836 0 151023 0 0 0 NONQUALIFIED RETIREMENT PLAN SCH J, PART I, LINE 4B LAUGHLIN MEMORIAL HOSPITAL HAS A SECTION 457(F) PLAN THAT PROVIDES FOR NON-ELECTIVE DISCRETIONARY CONTRIBUTIONS. PARTICIPANTS MUST BE EMPLOYED BY THE HOSPITAL FOR 12 MONTHS OF CONTINUOUS SERVICE DURING THE PLAN YEAR AND REMAIN EMPLOYED AT THE END OF THE PLAN YEAR. PARTICIPANTS VESTED PERCENTAGE REMAINS AT 0% UNTIL COMPLETION OF 10 FULL YEARS OF PLAN PARTICIPATION. PARTICIPANTS ARE 100% VESTED AFTER 10 YEARS, UPON DEATH OR DISABILITY THAT RESULTS IN SEVERANCE OF EMPLOYMENT, ATTAINMENT OF NORMAL RETIREMENT AGE (65), TERMINATION OF EMPLOYMENT BY REDUCTION IN FORCE, OR THE SALE OR CLOSURE OF SUBSTANTIALLY ALL OF THE HOSPITAL'S OPERATIONS. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN DURING THE CURRENT YEAR: CHARLES H. WHITFIELD, JR. $46,706 JOHN MARK COMPTON $21,620 ROBERT R. ROARK $16,059 HEALTH & EDUCATIONAL FACILITIES BOARD 621220275 394825AB9 2004-08-20 47000000 HOSPITAL CONSTRUCTION false false false 0 0 47000000 0 0 25830000 49917 0 0 21120083 0 0 2006 true false true true false false false false 0.00000 0.00000 0.00000 true false true true SUNTRUST 28. false false false 0 false false X RELATIONSHIPS AMONG OFFICERS, DIRECTORS AND KEY EMPLOYEES FORM 990, PART VI, SECTION A, LINE 2 ---------------------------------------- THE FOLLOWING FAMILY RELATIONSHIP EXISTS: CHARLES H. WHITFIELD, JR., PRESIDENT AND CEO, IS THE SON OF C. HERBERT WHITFIELD, SR., A DIRECTOR OF LAUGHLIN MEMORIAL HOSPITAL, INC. PROCESS TO REVIEW FORM 990 FORM 990, PART VI, SECTION B, LINE 11 ---------------------------------------- THE CEO VERIFIES THAT THE FORM 990 REFLECTS DATA COLLECTED BY THE ORGANIZATION. A REVIEW OF HIGHLIGHTS IS CONDUCTED BY THE CEO AND BOARD. MONITORING THE CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINES 12B AND 12C ---------------------------------------- ALL BOARD MEMBERS AND DEPARTMENT HEADS SIGN A STATEMENT ANNUALLY TO INDICATE THAT THEY HAVE NO CONFLICTS OF INTEREST OR DESCRIBING THE NATURE OF ANY POTENTIAL CONFLICTS OF INTEREST. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON THE INTRANET AND THE COMPLIANCE OFFICER REVIEWS THE CONFLICT OF INTEREST STATEMENTS EACH YEAR. BOARD MEMBERS DO NOT VOTE ON ISSUES WHERE THEIR INTERESTS COULD CONFLICT WITH THOSE OF THE ORGANIZATION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINES 15A AND 15B ---------------------------------------- A COMPENSATION REVIEW WAS CONDUCTED BY THE COMPENSATION COMMITTEE OF THE BOARD IN 2011 FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS. FOR OTHER OFFICERS AND KEY EMPLOYEES, A REVIEW IS CONDUCTED ANNUALLY AS PART OF THE EMPLOYEE'S ANNUAL PERFORMANCE APPRAISAL. MAKING FORMS AVAILABLE TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 ---------------------------------------- CONFLICT OF INTEREST POLICIES ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND ARE AVAILABLE ON THE EMPLOYEE INTRANET. REQUESTS FOR GOVERNING DOCUMENTS OR FINANCIAL STATEMENTS ARE CONSIDERED BY THE CEO AND CFO BASED ON THE BEST INTEREST OF THE ORGANIZATION AND ITS HEALTHCARE MISSION. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 ---------------------------------------- OTHER CHANGES IN NET ASSETS: UNREALIZED LOSSES ($2,290,775) CHANGE IN INTEREST OF LAUGHLIN HEALTHCARE FDN $47,120 CHANGE IN VALUE OF INTEREST SWAP ($2,130,178) ROUNDING (1) ------------- ($4,373,834) LAUGHLIN HEALTHCARE FOUNDATION 1420 TUSCULUM BLVD GREENEVILLE TN 37745 582105493 FUNDRAISING TN 5014(c)(3) 11 NA false NOLICHUCKEY MANAGEMENT SERVICES INC 1420 TUSCULUM BLVD GREENEVILLE TN 377454279 621776681 DOCTOR OFFICES TN NA C CORPORATION -339851 113276 1.00000 false true true false false false false true false false false true true true true true true true LAUGHLIN HEALTHCARE FOUNDATION C 181657 FMV