OHIO COUNTY HOSPITAL CORPORATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- OHIO COUNTY HOSPITAL CORPORATION (EIN 31-1131099)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-05-14
- IRS object ID
- 201331349349304403
- Schema version
- 2011v1.5
- 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
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T13:33:06-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621046406 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON HICKEY & MURCHISON PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 651 E FOURTH ST STE 200 | AddressLine1 |
| City | CHATTANOOGA | City |
| State | TN | State |
| ZIP Code | 37403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311131099 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OHIO COUNTY HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OHIO | NameControl |
| Phone | 2702987411 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1 |
| City | HARTFORD | City |
| State | KY | State |
| ZIP Code | 42347 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN TICHENOR | Name |
| Title | CFO | Title |
| Phone | 2702987411 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BARRY R HUGGINS | Name |
| PTIN | P00627334 | PTIN |
| Phone | 4237560052 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BLAINE PIEPER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1 |
| City | HARTFORD | City |
| State | KY | State |
| ZIP Code | 42347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 31542361 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.OHIOCOUNTYHOSPITAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | THE 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 427 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 221615 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 116998 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26949560 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 29944255 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8525 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5589 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 596714 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1475519 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 27776414 | TotalRevenuePriorYear |
| Total Revenue Current Year | 31542361 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13809777 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16535223 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14174384 | OtherExpensePriorYear |
| Other Expenses Current Year | 14970911 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 27984161 | TotalExpensesPriorYear |
| Total Expenses Current Year | 31506134 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -207747 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 36227 | RevenuesLessExpensesCY |
| Total Assets BOY | 17061058 | TotalAssetsBOY |
| Total Assets EOY | 17467563 | TotalAssetsEOY |
| Total Liabilities BOY | 8320068 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8690346 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8740990 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8777217 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 28155984 | Expense |
| Revenue | 31371941 | Revenue |
| Description | THE 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 2011, THE HOSPITAL PROVIDED HEALTH CARE SERVICES TO OHIO COUNTY KENTUCKY AND SURROUNDING AREAS, INCLUDING INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. OHIO COUNTY HOSPITAL PROVIDED $2,397,115 OF CHARITY CARE THROUGH ITS CHARITY CARE PROGRAM. IN ADDITION, THEY PROVIDED $74,183 WORTH OF PROFESSIONAL/HOSPITAL SERVICES THAT WERE NOT REIMBURSED BY ANY STATE PROGRAMS. | Description |
| Total Program Service Expense | 28155984 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 427 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | KY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN TICHENOR | NamePerson |
| Telephone Number | 2702985495 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1 |
| City | HARTFORD | City |
| State | KY | State |
| ZIP Code | 42347 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JUANITA PARK | |||||||
| PRESIDENT | 2.00 | X | X | 0 | 0 | 0 | |
| JANE CANARY | |||||||
| VICE PRESIDENT | 2.00 | X | X | 0 | 0 | 0 | |
| JONATHAN SHREWBURY OD | |||||||
| SECRETARY/TREASURER | 2.00 | X | X | 0 | 0 | 0 | |
| LLOYD SPIVEY | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| WAYNE HUNSAKER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| KELLY ROE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CARLA WALLACE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| GERALD WESTERFIELD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DRANDERSON ROWLAND | |||||||
| PHYSICIAN | 40.00 | X | 209786 | 0 | 0 | ||
| BLAIN PIEPER | |||||||
| CEO | 40.00 | X | 143064 | 0 | 16452 | ||
| JOHN TICHENOR | |||||||
| CFO | 40.00 | X | 106378 | 0 | 11494 | ||
| BRENDA NEWCOM | |||||||
| CHIEF NURSING OFFICER | 40.00 | X | 80729 | 0 | 11320 | ||
| HEATHER GARRETT | |||||||
| PHYSICIAN/MEDICAL STAFF PRES. | 40.00 | X | 311050 | 0 | 15085 | ||
| JANNA PATHI | |||||||
| CMO/SURGEON | 40.00 | X | 485881 | 0 | 12096 | ||
| DONALD K GREGORY | |||||||
| ER PHYSICIAN/HOSPITALIST | 40.00 | 374556 | 0 | 12889 | X | ||
| MUKESH DESAI | |||||||
| UROLOGIST | 40.00 | 590749 | 0 | 18136 | X | ||
| JOSHUA SKIBBA | |||||||
| CARDIOLOGIST | 40.00 | 424392 | 0 | 4904 | X | ||
| CHARLES RICCIO | |||||||
| GASTROENTEROLOGIST | 40.00 | 351614 | 0 | 10056 | X | ||
| JOEL JOHNSTON | |||||||
| PHYSICIAN ER | 40.00 | 280944 | 0 | 18276 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3359143 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 130708 | TotalOtherCompensation |
| Number Individuals GT100 K | 19 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EMCARE PHYSICIAN SERVICES | |||||
| 7032 COLLECTION CENTER PLACE | CHICAGO | IL | 60693 | ER PHYSICIANS | 336218 |
| QUOROM HEALTH RESOURCES | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TN | 37027 | MANAGEMENT FEES | 248580 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 84802 | GovernmentGrants |
| All Other Contributions | 32196 | AllOtherContributions |
| Total Contributions | 116998 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICES | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 29944255 | TotalRevenueColumn |
| Related Or Exempt Function Income | 29944255 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 29944255 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5589 | TotalRevenueColumn |
| Exclusion | $5,589 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 47833 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 47833 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 47833 | TotalRevenueColumn |
| Exclusion | $47,833 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PHARMACY SALES | 446110 | 1004311 | 1004311 |
| MISCELLANEOUS INCOME | 621300 | 348226 | 348226 |
| CAFETERIA INCOME | 722210 | 57795 | 57795 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17354 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17354 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1427686 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31542361 | TotalRevenueColumn |
| Related Or Exempt Function Income | 31371941 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $53,422 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1193549 | Total |
| Program Services | 916161 | ProgramServices |
| Management And General | 277388 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12764168 | Total |
| Program Services | 12190372 | ProgramServices |
| Management And General | 573796 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249854 | Total |
| Program Services | 234863 | ProgramServices |
| Management And General | 14991 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1388883 | Total |
| Program Services | 1305550 | ProgramServices |
| Management And General | 83333 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 938769 | Total |
| Program Services | 882443 | ProgramServices |
| Management And General | 56326 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 248580 | Total |
| Management And General | 248580 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57673 | Total |
| Management And General | 57673 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57815 | Total |
| Management And General | 57815 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2245112 | Total |
| Program Services | 1645031 | ProgramServices |
| Management And General | 600081 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66154 | Total |
| Program Services | 66154 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93334 | Total |
| Program Services | 80869 | ProgramServices |
| Management And General | 12465 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2136614 | Total |
| Program Services | 1776087 | ProgramServices |
| Management And General | 360527 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112963 | Total |
| Program Services | 96813 | ProgramServices |
| Management And General | 16150 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239647 | Total |
| Program Services | 239647 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1070631 | Total |
| Program Services | 1070631 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 432449 | Total |
| Program Services | 16733 | ProgramServices |
| Management And General | 415716 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES AND DR | 4702232 | 4702232 | |
| BAD DEBT | 2597116 | 2597116 | |
| TAXES AND LICENSES | 479188 | 479188 | |
| OTHER SUPPLIES | 312509 | 255309 | 57200 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118894 | Total |
| Program Services | 79973 | ProgramServices |
| Management And General | 38921 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31506134 | Total |
| Program Services | 28155984 | ProgramServices |
| Management And General | 3350150 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2015945 | BOY |
| EOY | 1733210 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1455516 | BOY |
| EOY | 1064120 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4209202 | BOY |
| EOY | 4417612 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 775893 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 739514 | BOY |
| EOY | 833134 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150562 | BOY |
| EOY | 171589 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 23698618 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15518019 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8258343 | BOY |
| EOY | 8180599 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 231976 | BOY |
| EOY | 291406 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17061058 | BOY |
| EOY | 17467563 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1602919 | BOY |
| EOY | 2196201 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 262927 | BOY |
| EOY | 357694 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5455000 | BOY |
| EOY | 4880000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 404221 | BOY |
| EOY | 599378 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 595001 | BOY |
| EOY | 657073 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8320068 | BOY |
| EOY | 8690346 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8740990 | BOY |
| EOY | 8777217 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8740990 | BOY |
| EOY | 8777217 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17061058 | BOY |
| EOY | 17467563 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 36227 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $2,174 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2174 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE HOSPITAL PAYS DUES TO THE KENTUCKY HOSPITAL ASSSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 441841 | OtherCostOrOtherBasis |
| Book Value | 441841 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8343822 | OtherCostOrOtherBasis |
| Depreciation | 3667571 | Depreciation |
| Book Value | 4676251 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14405882 | OtherCostOrOtherBasis |
| Depreciation | 11563863 | Depreciation |
| Book Value | 2842019 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 507073 | OtherCostOrOtherBasis |
| Depreciation | 286585 | Depreciation |
| Book Value | 220488 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8180599 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THIRD PARTY SETTLEMENTS | Description |
| Amount | $657,073 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 657073 | TotalOfAmounts |
| Total Revenue | 31542361 | TotalRevenue |
| Total Expenses | 31506134 | TotalExpenses |
| Excess Or Deficit For Year | 36227 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 36227 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 31542361 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 31542361 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 31542361 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 31506134 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 31506134 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 31506134 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE 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, 2012 AND 2011. AS OF SEPTEMBER 30, 2012 AND 2011, 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 2009. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1797057 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 470540 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1326517 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04590 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4233510 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3190939 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1042571 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03610 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6030567 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3661479 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2369088 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08200 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25219 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 25219 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22221 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 22221 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 47440 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 47440 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6078007 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3661479 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2416528 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08370 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $1,455,473 | BadDebtExpenseAmount |
| Amount Attributable To | 1343317 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 8799573 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8712448 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 87125 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OHIO COUNTY HOSPITAL CORPORATION | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 OLD MAIN STREET | AddressLine1 |
| City | HARTFORD | City |
| State | KY | State |
| ZIP Code | 42347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OHIO HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| 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 $ 2597116. | |
| PART II: OHIO COUNTY HOSPITAL IS A MAJOR FINANCIAL CONTRIBUTOR, AS WELL PROVIDES STAFF TO COORDINATE LONGEST DAY OF PLAY AND CELEBRATE THE CHILD, TWO OF THE LARGEST COMMUNITY OUTREACHES TARGETED TO CHILDREN. BOTH OF THESE EVENTS ARE PROVIDED FREE TO THE YOUTH OF THE COMMUNITY. CELEBRATE THE CHILD DRAWS THOUSANDS OF COMMUNITY MEMBERS ANNUALLY AND FOCUS ON COMMUNITY ASSET BUILDING. OHIO COUNTY HOSPITAL SUBSIDIZES THE ADVERTISEMENT AND SUPPLIES FOR THE EVENT AND OUR STAFF PARTICIPATES IN A HOSPITAL BOOTH WHICH FOCUS ON CHILDREN MAKING HEALTHY FOOD CHOICES. LONGEST DAY OF PLAY IS AN ANNUAL SUMMER EVENT WHERE FAMILIES CAN PARTICIPATE IN OVER 30 OUTDOOR PHYSICAL ACTIVITIES. OVER 1000 COMMUNITY MEMBERS ATTEND IN ADDITION TO THE HUNDRED PLUS COMMUNITY VOLUNTEERS. 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. OHIO 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, BREAST CANCER AWARENESS EVENTS, DIABETES SUPPORT GROUP, GRIEF SUPPORT GROUP THROUGH HOSPICE, GO BLUE PROSTRATE CANCER EDUCATION EVENTS, ANNUAL OCH FALL INTO FITNESS 5K AND OCH SUMMER SIZZLE 5K, COMMUNITY FITNESS CHALLENGE. OHIO COUNTY HOSPITAL ALSO PROVIDES MEETING SPACE FOR RETIRED TEACHERS ASSOCIATION, FREE SMOKING CESSATION PROGRAM, HOSPITAL EMPLOYEE UNITED WAY FUND-DRIVE, AND HABITAT FOR HUMANITY FALL FESTIVAL, HEALTH STUDENTS CAREER DAY; HOSPITAL STAFF PARTICIPATES IN THE COMMUNITY SCHOOL SYSTEM BACK TO SCHOOL BASHES TO DISTRIBUTE INFORMATION ON CHILDHOOD IMMUNIZATIONS. ADDITIONALLY, HOSPITAL STAFF IS INVOLVED IN COMMUNITY READER DAYS, LEADERSHIP OHIO COUNTY REALITY STORE, STUDENT MENTORING PROGRAM THROUGHOUT THE SCHOOL SYSTEM AND THE 4-H BODY WALK - AN INTERACTIVE DISPLAY TO TEACH MIDDLE SCHOOL STUDENTS ABOUT THE HUMAN BODY. | |
| PART III, LINE 4: 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: IF A PATIENT HAS BEEN APPROVED BY THE CHARITY CARE PROGRAM WITHIN A SIX MONTH TIME FRAME, THE ACCOUNT IS WRITTEN OFF AS A CHARITY CARE ADJUSTMENT. THE FINANCIAL COUNSELORS CHECK EACH PRIVATE PAY ACCOUNT AND WILL FOLLOW UP TO MAKE SURE THAT THEY HAVE RECEIVED AND ARE GOING TO COMPLETE THEIR PAPERWORK. THE HOSPITAL CONTRACTS WITH DMC, INC, AND THEY WILL ASSIST PATIENTS WITH CHARITY CARE PAPERORK IF THEY DO NOT QUALIFY FOR MEDICAID. | |
| PART V, SECTION B, LINE 15E: 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. | OHIO HOSPITAL CORPORATION |
| PART VI, LINE 2: FOR THE PAST SEVERAL YEARS, THE GREEN RIVER REGIONAL HEALTH COUNCIL (GRADD HEALTH COUNCIL), A NETWORK OF ORGANIZATIONS AND INDIVIDUALS COMMITTED TO IMPROVING THE HEALTH OF THE AREA, HAS WORKED ON SOLUTIONS TO ADDRESS A MYRIAD OF HEALTH RELATED CONCERNS IN THE REGION. GRADD HEALTH COUNCIL, IN PART THROUGH A FEDERALLY FUNDED RURAL HEALTH NETWORK GRANT, ESTABLISHED LOCAL HEALTH COUNCILS IN EACH OF THE REGION'S RURAL COUNTIES, INCLUDING OHIO COUNTY. THE OHIO COUNTY HEATH COALITION MET REGULARLY FOCUSING ON SUBSTANCE ABUSE, MATERNAL AND CHILD CARE HEALTH, AND BUSINESS AND INDUSTRIAL WELLNESS. OHIO COUNTY HOSPITAL HAS BEEN ACTIVE IN THIS COALITION SINCE ITS INCEPTION.IN 2012, THE GREEN RIVER DISTRICT HEALTH DEPARTMENT (GRDHD), A MEMBER OF THE GRADD HC, AGREED TO PROVIDE LEADERSHIP TO BRING ABOUT A MORE SCIENTIFIC APPROACH TO ASSESSING THE COMMUNITY NEEDS IN EACH OF THE SEVEN COUNTIES IN THE DISTRICT. UTILIZING A PROCESS KNOWN AS MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP), GRDHD PARTNERED WITH UNIVERSITY OF KENTUCKY'S APPALACHIA PUBLIC HEALTH TRAINING CENTER. 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 COMMUNITY'S 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; AND 3) 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 DISTRICT'S COUNTIES. THIS PLAN WAS REVIEWED WITH THE OHIO COUNTY HEALTH COALITION AND OTHER COMMUNITY PARTNERS. IN DECEMBER 2012, THE OHIO COUNTY HEALTH COALITION MET IN A STRATEGIC PLANNING RETREAT TO REVIEW THE THREE STRATEGIC INITIATIVES OBTAINED THROUGH THE MAPP PROCESS. THE COALITION BEGAN TO IDENTIFY ACTION PLANS TO FOCUS COALITION MEMBER'S EFFORTS. FURTHERMORE, SPECIFIC MEASURES ARE BEING IDENTIFIED TO TRACK PROGRESS. THE COALITION WILL CONTINUE TO MEET REGULARLY TO FURTHER DEVELOP AND RESOLVE THESE MATTERS. | |
| 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 INFORMAITON 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. THE HOSPITAL'S 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 2012 WAS 24,103. THE PER CAPITA INCOME (MEAN INCOME FOR EVERY MAN, WOMAN, AND CHILD IN A PARTICULAR GROUP) FOR OHIO COUNTY IS $20,401 COMPARED TO THE KENTUCKY AVERAGE OF $27,625 AND NATIONAL AVERAGE OF $33,689. OHIO COUNTY HAS BEEN DESIGNATED A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVICED AREA / POPULATION (MUA/P). 19% OF OHIO COUNTY'S POPULATION FALLS BELOW THE POVERTY LEVEL, COMPARED TO 13.8% NATIONWIDE. 29% OF HOUSEHOLDS IN OUR COMMUNITY INCLUDE CHILDREN LIVING IN A SINGLE PARENT HOME. 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 17% OF ADULTS IN THE OHIO COUNTY COMMUNITY 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 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. OHIO COUNTY HOSPITAL HAS ESTABLISHED A HEALTH IMPROVEMENT PROGRAM WHICH PROVIDES A PRIMARY-CARE HOME, PREVENTIVE SCREENINGS, DIETARY AND PHYSICAL FITNESS COUNSELING TO THE UN-INSURED AND UNDER-INSURED POPULATION OF OUR COMMUNITY. THE HOSPITAL RESEARCHES AND COMPLETES NUMEROUS GRANT APPLICATIONS APPLICABLE TO PROMOTING THE HEALTH OF OUR COMMUNITY. 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DRANDERSON ROWLAND | |||||||||||||
| 179051 | 0 | 30735 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 209786 | 0 | 0 | 0 |
| BLAIN PIEPER | |||||||||||||
| 143064 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 16452 | 0 | 159516 | 0 | 0 | 0 |
| HEATHER GARRETT | |||||||||||||
| 216818 | 0 | 94232 | 0 | 0 | 0 | 0 | 0 | 15085 | 0 | 326135 | 0 | 0 | 0 |
| JANNA PATHI | |||||||||||||
| 485881 | 0 | 0 | 0 | 0 | 0 | 8331 | 0 | 3765 | 0 | 497977 | 0 | 0 | 0 |
| DONALD K GREGORY | |||||||||||||
| 374556 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12889 | 0 | 387445 | 0 | 0 | 0 |
| MUKESH DESAI | |||||||||||||
| 590749 | 0 | 0 | 0 | 0 | 0 | 8231 | 0 | 9905 | 0 | 608885 | 0 | 0 | 0 |
| JOSHUA SKIBBA | |||||||||||||
| 424392 | 0 | 0 | 0 | 0 | 0 | 4904 | 0 | 0 | 0 | 429296 | 0 | 0 | 0 |
| CHARLES RICCIO | |||||||||||||
| 351614 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 10056 | 0 | 361670 | 0 | 0 | 0 |
| JOEL JOHNSTON | |||||||||||||
| 280944 | 0 | 0 | 0 | 0 | 0 | 6199 | 0 | 12077 | 0 | 299220 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | JOHN TICHENOR AND BLAINE PIEPER ARE CONTRACTED THROUGH QUORUM HEALTH RESOURCES, INC FOR THEIR MANAGEMENT SERVICES. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| OHIO COUNTY PUBLIC FACILITIES CORPORATION | |||||||
| 616000805 | 000677292 | 2005-08-01 | 4240000 | HOSPITAL CONSTRUCTION | 0 | 0 | 0 |
| OHIO COUNTY PUBLIC FACILITIES CORPORATION | |||||||
| 616000805 | 2010-09-29 | 3620000 | MEDICAL OFFICE BUILDING CONSTRUCTION | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 1445000 | 424000 | 74823 | 3741177 | 2006 | 1 | 0 | 1 | 1 |
| 3435000 | 273400 | 70000 | 3550000 | 2011 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 1 | 0 | 0 | 0 | 0 |
| 1 | 1 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| DR DAVID RIZK | ||||||
| STUDENT LOAN/BONUS | X | $121,500 | 83531 | 0 | 1 | 1 |
| DR DESAI | ||||||
| SIGNON BONUS | X | $145,737 | 106874 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 190405 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL CONTRACTS WITH QUORUM HEALTH RESOURCES, INC (QHR)TO PROVIDE MANAGEMENT SERVICES UNDER AN AGREEMENT WHICH EXPIRES IN 2013. THE CONTRACT REQUIRED QHR TO SUPPLY A CHIEF EXECUTIVE OFFICER AND A CHIEF FINANCIAL OFFICER WHOSE SALARY AND BENEFITS COST ARE PASSED DIRECTLY THROUGH TO THE HOSPITAL. THE HOSPITAL'S EXPENSE FOR THE MANAGEMENT FEE TOTALED APPOXIMATELY $236,743 FOR THIS YEAR. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS PROVIDED TO THE FULL BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS ARE COVERED UNDER THIS POLICY AND ANY CONFLICTS ARE RESOLVED AT MONTHLY BOARD MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE 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 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |