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HARRISON MEMORIAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HARRISON MEMORIAL HOSPITAL (EIN 61-0420440)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-13
IRS object ID
201342259349302114
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-13T14:02:17-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN273858252EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DEAN DORTON ALLEN FORD PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1106 W VINE STREET SUITE 600AddressLine1
CityLEXINGTONCity
StateKYState
ZIP Code40507ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN610420440EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHARRNameControl
Phone8592353502Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EAddressLine1
CityCYNTHIANACity
StateKYState
ZIP Code410317498ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJIM SPEARS CFOName
TitleCEOTitle
Phone8592353502Phone
Date Signed2013-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLEIGH MCKEEName
PTINP00169845PTIN
Phone8592552341Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSHEILA CURRANSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EAddressLine1
CityCYNTHIANACity
StateKYState
ZIP Code410317498ZIPCode
FieldValueIRS element (for citing)
Gross Receipts37884919GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HARRISONMEMHOSP.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileKYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HIGH QUALITY HEALTH AND MEDICAL CARE TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees395TotalNbrEmployees
Total Nbr Volunteers17TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year44675ContributionsGrantsPriorYear
Contributions Grants Current Year12860ContributionsGrantsCurrentYear
Program Service Revenue Prior Year35756961ProgramServiceRevenuePriorYear
Program Service Revenue CY37073664ProgramServiceRevenueCY
Investment Income Prior Year12438InvestmentIncomePriorYear
Investment Income Current Year13489InvestmentIncomeCurrentYear
Other Revenue Prior Year643591OtherRevenuePriorYear
Other Revenue Current Year656973OtherRevenueCurrentYear
Total Revenue Prior Year36457665TotalRevenuePriorYear
Total Revenue Current Year37756986TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year17153890SalariesEtcPriorYear
Salaries Etc Current Year17243340SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year17934135OtherExpensePriorYear
Other Expenses Current Year17383327OtherExpensesCurrentYear
Total Expenses Prior Year35088025TotalExpensesPriorYear
Total Expenses Current Year34626667TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1369640RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3130319RevenuesLessExpensesCY
Total Assets BOY38087354TotalAssetsBOY
Total Assets EOY40306782TotalAssetsEOY
Total Liabilities BOY21874705TotalLiabilitiesBOY
Total Liabilities EOY20767791TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16212649NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19538991NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHARRISON MEMORIAL HOSPITAL EXISTS FOR THE PURPOSE OF PROVIDING HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES OF OUR REGION WITHIN THE CAPABILITIES OF OUR RESOURCES. IN FULFILLING THIS MISSION, WE STRIVE FOR EXCELLENCE IN: THE CARE WE DELIVER; IN PATIENT SAFETY; IN THE FACILITIES WE PROVIDE; IN THE RECRUITMENT, RETENTION, AND DEVELOPMENT OF DEDICATED PHYSICIANS AND PERSONNEL; IN FACILITATING, COORDINATING AND PROVIDING ACCESS TO GENERAL AND SPECIALIZED HEALTH SERVICES THROUGH OUR OWN RESOURCES AND IN COLLABORATION WITH THE RESOURCES OF OTHERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense27748423Expense
Revenue37073664Revenue
DescriptionTHE HOSPITAL PROVIDED HEALTH CARE TO 1,681 IN-PATIENTS, 224 NURSERY PATIENTS AND 55,002 OUT-PATIENTS. THE HOSPITAL HAS A HIGH VOLUME OF MEDICARE AND MEDICAID PATIENTS. THE HOSPITAL TREATS ALL PATIENTS REGARDLESS OF ABILITY TO PAY. HARRISON MEMORIAL HOSPITAL PROVIDED APPROXIMATELY $749,000 OF CHARITY CARE AT COST.Description
Total Program Service Expense27748423TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person1GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109653NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees395NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledKYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JIM SPEARSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8592353502TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EAddressLine1
CityCYNTHIANACity
StateKYState
ZIP Code410317498ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ALEX BARNETT
DIRECTOR1.00X000
GERALD FIELDS
DIRECTOR1.00X000
DOUG HAMPTON
CHAIRMAN1.00X000
JOHN LAIR
DIRECTOR1.00X000
MS BRUCE FLORENCE
DIRECTOR1.00X000
DR BRIAN MULBERRY
DIRECTOR1.00X000
DR FRANK MCKEMIE
CHAIRMAN-ELECT1.00X000
LARRY WILEY
DIRECTOR1.00X000
JANE THOMAS
DIRECTOR1.00X000
DR STEPHEN MOSES
DIRECTOR1.00X000
FRAZER LEBUS
DIRECTOR1.00X000
STEVE JUDY
DIRECTOR1.00X000
STEVE MOSES
DIRECTOR1.00X000
PAUL TUCKER
DIRECTOR1.00X000
SHEILA CURRANS
COO40.00174245011725X
JIM SPEARS
CFO40.0014441904846X
GERALD HARPEL MD
PHYSICIAN40.0039642804272X
NEZAR M FALLUJI
PHYSICIAN40.0036587300X
JAMES PETTY
PHYSICIAN40.0050520202963X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1586167TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation23806TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MESSER CONSTRUCTION
854 W MAIN STREETLEXINGTONKY40508CONSTRUCTION CONTRACTOR1603590
COMMUNITY ANESTHESIA OF THE BLUEGRASS
1210 KY HWY 36ECYNTHIANAKY41031ANESTHESIA SERVICES523176
MARSHALL EMERGENCY SERVICES
3205 SUMMIT SQUARE PLACE SUITE 100LEXINGTONKY40509ER PHYSICIANS431453
KENTUCKY MEDICAL SERVICES FOUNDATION INC
138 LEADER AVENUELEXINGTONKY40508ONCOLOGY & SURGERY PHYSICIANS240948
NEW LEXINGTON CLINIC PSC
1221 SOUTH BROADWAYLEXINGTONKY40504UROLOGY PHYSICIANS216903
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions12860AllOtherContributions
Total Contributions12860TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUDescription
Business Code623990BusinessCode
Total Revenue Column37073664TotalRevenueColumn
Related Or Exempt Function Income37073664RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue37073664TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column14372TotalRevenueColumn
Exclusion$14,372ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real144032Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real125550Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real18482Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column18482TotalRevenueColumn
Exclusion$18,482ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2383Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-883Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-883TotalRevenueColumn
Exclusion-$883ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA/VENDING722210206892$206,892
DAY CARE624410184033$184,033
OTHER REVENUE90009980864$80,864

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column166702TotalRevenueColumn
Exclusion$166,702ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue638491TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column37756986TotalRevenueColumn
Related Or Exempt Function Income37073664RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$670,462ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total371010Total
Management And General371010ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total14030548Total
Program Services10643574ProgramServices
Management And General3386974ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total310440Total
Program Services235500ProgramServices
Management And General74940ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1533927Total
Program Services1163637ProgramServices
Management And General370290ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total997415Total
Program Services756639ProgramServices
Management And General240776ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total28587Total
Management And General28587ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total43678Total
Management And General43678ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2529680Total
Program Services1919015ProgramServices
Management And General610665ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total180993Total
Program Services137301ProgramServices
Management And General43692ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total195024Total
Program Services147945ProgramServices
Management And General47079ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total590282Total
Program Services447788ProgramServices
Management And General142494ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total43131Total
Program Services32719ProgramServices
Management And General10412ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total861210Total
Program Services861210ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2642049Total
Program Services2642049ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total375240Total
Program Services284657ProgramServices
Management And General90583ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DRUGS & SUPPLIES47967124015325781387
BAD DEBT EXPENSE20057242005724
OUTSOURCING13977381060324337414
KY PROVIDER TAX549805549805

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1143474Total
Program Services845211ProgramServices
Management And General298263ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total34626667Total
Program Services27748423ProgramServices
Management And General6878244ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7562526BOY
EOY6272463EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2978063BOY
EOY3723284EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY181589BOY
EOY139987EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY801619BOY
EOY810665EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY555915BOY
EOY655436EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis51039969LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec27708595LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY22808998BOY
EOY23331374EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2106908BOY
EOY4212753EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY410429BOY
EOY379169EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY681307BOY
EOY781651EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY38087354BOY
EOY40306782EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2333842BOY
EOY2316800EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY200482BOY
EOY94139EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY17145000BOY
EOY16721694EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1702375BOY
EOY1460575EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY493006BOY
EOY174583EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY21874705BOY
EOY20767791EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY15619259BOY
EOY18855406EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY593390BOY
EOY683585EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16212649BOY
EOY19538991EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY38087354BOY
EOY40306782EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3130319ReconcilationRevenueExpenses
Reconcilation Other Changes196023ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$2,565OtherActivitiesAmount
Total Lobbying Expenditures IIB2565TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationTHE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE KENTUCKY HOSPITAL ASSOCIATION AND PAID DUES OF $14,250 OF WHICH $2,565 IS ATTRIBUTABLE TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis137233OtherCostOrOtherBasis
Book Value137233BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23135644OtherCostOrOtherBasis
Depreciation9919394Depreciation
Book Value13216250BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis98630OtherCostOrOtherBasis
Depreciation14794Depreciation
Book Value83836BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis24118671OtherCostOrOtherBasis
Depreciation16887387Depreciation
Book Value7231284BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3549791OtherCostOrOtherBasis
Depreciation887020Depreciation
Book Value2662771BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23331374TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTY PAYORS$156,383
PHYSICIAN COMMITMENTS$18,200
FieldValueIRS element (for citing)
Total Of Amounts174583TotalOfAmounts
Total Revenue37756986TotalRevenue
Total Expenses34626667TotalExpenses
Excess Or Deficit For Year3130319ExcessOrDeficitForYear
Net Unrealized GL On Investments196023NetUnrealizedGLOnInvestments
Total Adjustments196023TotalAdjustments
Excess Or Deficit Per FS3326342ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt38078559TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments196023NetUnrealizedGainsInvestments
Other Revenues125550OtherRevenues
Revenue Not Rptd F990321573RevenueNotRptdF990
Revenue Subtotal37756986RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99037756986TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt34752217TotExpensesEtcAuditedFinclStmt
Other Expenses Included125550OtherExpensesIncluded
Expenses Not Rptd F990125550ExpensesNotRptdF990
Expenses Subtotal34626667ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99034626667TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL HAS ADOPTED THE PROVISIONS OF GAAP RELATING TO UNCERTAINTY IN INCOME TAXES. THE ASSESSMENT INCLUDES EVALUATING THE TAX POSITIONS TAKEN ON ALL INCOME TAX RETURNS THAT REMAIN OPEN TO EXAMINATION BY THE RESPECTIVE TAXING AUTHORITIES (RETURNS FILED AFTER 2008). THE HOSPITAL DOES NOT BELIEVE THAT THERE ARE ANY UNCERTAIN TAX POSITIONS ON THOSE RETURNS THAT SHOULD BE REFLECTED IN THE FINANCIAL STATEMENTS.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NETTED AGAINST RENTAL INCOME ON PAGE 1
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NETTED AGAINST RENTAL INCOME ON PAGE 1

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense835540TotalCommunityBenefitExpense
Direct Offsetting Revenue963362DirectOffsettingRevenue
Net Community Benefit Expense-127822NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5690678TotalCommunityBenefitExpense
Direct Offsetting Revenue4803416DirectOffsettingRevenue
Net Community Benefit Expense887262NetCommunityBenefitExpense
Percent Of Total Expense0.02560PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6526218TotalCommunityBenefitExpense
Direct Offsetting Revenue5766778DirectOffsettingRevenue
Net Community Benefit Expense759440NetCommunityBenefitExpense
Percent Of Total Expense0.02560PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense582167TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense582167NetCommunityBenefitExpense
Percent Of Total Expense0.01680PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense3400TotalCommunityBenefitExpense
Net Community Benefit Expense3400NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense585567TotalCommunityBenefitExpense
Net Community Benefit Expense585567NetCommunityBenefitExpense
Percent Of Total Expense0.01690PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense7111785TotalCommunityBenefitExpense
Direct Offsetting Revenue5766778DirectOffsettingRevenue
Net Community Benefit Expense1345007NetCommunityBenefitExpense
Percent Of Total Expense0.04250PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,005,724BadDebtExpenseAmount
Amount Reimbursed By Medicare9112537AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9197439CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-84902MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36 EASTAddressLine1
CityCYNTHIANACity
StateKYState
ZIP Code41031ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HARRISON MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted11NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed1AllNeedsAddressed
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent150.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: AMOUNTS WERE DETERMINED USING A COST-TO-CHARGE RATIO DERIVED FROM THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H.
PART I, L7 COL(F): $2,005,724 OF BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A) WAS REMOVED FROM THE DENOMINATOR OF THIS CALCULATION PER THE INSTRUCTIONS.
PART II: HARRISON MEMORIAL HOSPITAL IS VERY ACTIVE IN THE COMMUNITY WITH PROMOTING HEALTH EDUCATION. HMH PARTNERS WITH SEVERAL COMMUNITY ORGANIZATIONS TO REACH THE LARGEST AUDIENCE. IN MOST RECENT YEARS, HMH HAS PROVIDED HEALTH FAIRS AND SEMINARS IN SEVERAL COUNTIES LIKE PENDLETON, BRACKEN AND ROBERTSON. BY PROVIDING THESE EVENTS, HMH IS ABLE TO PROVIDE EDUCATION AND SCREENINGS MORE LOCALLY FOR THE RESIDENTS. IN ADDITION, THE EVENTS AID IN BUILDING RELATIONSHIPS WITH COMMUNITY LEADERS AND RESIDENTS. THE EVENTS LIKE HEALTH FAIRS PROVIDE FREE TESTS AND SCREENINGS, WHICH WOULD NORMALLY COST $550 PER PERSON. THE HEALTH FAIRS PROVIDE AN OPPORTUNITY FOR THE UNDERINSURED AND UNINSURED TO RECEIVE MEDICAL CARE. THE EVENTS ALSO HAVE SEVERAL OPPORTUNITIES TO MEET WITH HEALTH CARE PROFESSIONALS TO DISCUSS HEALTH ISSUES. THE HMH SPONSORED EDUCATIONAL SEMINARS PROVIDE AN OPPORTUNITY FOR INDIVIDUALS TO MEET HEALTH CARE PROFESSIONALS AND DISCUSS MAJOR HEALTH TOPICS.
PART III, LINE 4: BAD DEBT COST REPRESENTS THE EXPENSE THE HOSPITAL INCURRED DUE TO NONPAYMENT OF HOSPITAL CHARGES INCLUDING, BUT NOT LIMITED TO, NONPAYMENT OF MEDICARE COINSURANCE AND DEDUCTIBLE AMOUNTS. THIS EXPENSE IS LISTED AS AN OPERATING EXPENSE ON THE FINANCIAL STATEMENTS.BAD DEBT COST IS CALCULATED BY MULTIPLYING THE BAD DEBT EXPENSE LISTED ON THE FINANCIAL STATEMENTS BY THE COST TO CHARGE RATIO COMPUTED ON WORKSHEET 2.
PART III, LINE 8: ALL THE SHORTFALL REPORTED IN LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. LINE 6 WAS COMPUTED USING REVENUE AMOUNTS LISTED ON THE SETTLEMENT WORKSHEETS ON THE AS-FILED MEDICARE COST REPORT.
PART V, SECTION B, LINE 3: INDIVIDUALS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH WERE INTERVIEWED DURING THE COURSE OF PREPARING THE COMMUNITY NEEDS ASSESSMENT. THESE INDIVIDUALS INCLUDED BOTH FAMILY AND SPECIALTY PHYSICIANS AND DIRECTORS OF LOCAL HEALTH DEPARTMENTS OF HARRISON COUNTY AND THE SURROUNDING COUNTIES AND THE MAYOR OF CYNTHIANA.HARRISON MEMORIAL HOSPITAL, INC.
PART VI, LINE 2: THE HOSPITAL COMPLETED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. IN ADDITION, HARRISON MEMORIAL HOSPITAL ASSESSES THE COMMUNITY THROUGH SEVERAL METHODS. THE HMH COMMUNITY CONSISTS OF A SEVEN-COUNTY AREA. HMH HAS TWO BOARD LEVEL COMMITTEES WHO PROVIDE RECOMMENDATIONS TO THE HMH BOARD OF DIRECTORS. PLANNING: MARKET SHARE ENHANCEMENT COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS AND HMH PHYSICIAN STAFF MEMBERS. THE COMMITTEE IS PRESENTED WITH MARKET SHARE DATA OF THE INPATIENT ACTIVITY OF THE HOSPITAL AND OF MAJOR SERVICE LINES LIKE CARDIOLOGY, ORTHOPEDICS. THE DATA INFORMS THE COMMITTEE WHERE PATIENTS IN THE HMH SERVICE AREA CHOOSE TO RECEIVE HEALTHCARE. THE DATA IS EXTRACTED FROM KENTUCKY INFOSUITE EACH QUARTER. THE REPORTS AID THE COMMITTEE IN MAKING DECISIONS IN REGARDS TO THE NEEDS OF THE COMMUNITY. EACH YEAR THE PMSE COMMITTEE HOSTS A STRATEGIC RETREAT INVITING HMH BOARD MEMBERS, PHYSICIAN STAFF MEMBERS AND SENIOR MANAGEMENT TO DISCUSS COMMUNITY NEEDS AND PLANS FOR THE FUTURE. ANOTHER BOARD LEVEL COMMITTEE IS CALLED MEDICAL STAFF DEVELOPMENT. THE COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS, HMH PHYSICIAN STAFF MEMBERS AND COMMUNITY VOLUNTEERS. EACH YEAR THE MEDICAL STAFF DEVELOPMENT COMMITTEE COMPLETES A PHYSICIAN NEEDS ASSESSMENT. THE ASSESSMENT DEMONSTRATES THE PHYSICIAN NEED IN THE AREA BASED ON POPULATION. THE ASSESSMENT IS USED TO FORM A PHYSICIAN RECRUITING PLAN FOR THE FUTURE AND IS RECOMMENDED TO THE BOARD FOR APPROVAL. FINALLY, THE HMH MEDICAL STAFF MEETINGS ARE HELD ONCE A MONTH WHERE MEMBERS OF THE HMH SENIOR MANAGEMENT ALSO ATTEND. WITHIN THESE MEETINGS, THE STAFF MEMBERS DISCUSS PATIENT NEEDS. THE INFORMATION GATHERED AT THESE MEETINGS AID IN THE DECISIONS OF SERVICE LINE ENHANCEMENT.
PART VI, LINE 3: NOTIFICATION ABOUT CHARITY AVAILABLE FROM HARRISON MEMORIAL HOSPITAL , WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY HARRISON MEMORIAL HOSPITAL BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, SPECIALTY PHYSICIAN CLINICS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES, AND PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES AS HARRISON MEMORIAL HOSPITAL MAY ELECT. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY HARRISON MEMORIAL HOSPITAL. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE HARRISON MEMORIAL HOSPITAL STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.
PART VI, LINE 4: HARRISON MEMORIAL HOSPITAL SERVES SEVEN COUNTIES IN THE CENTRAL KENTUCKY AREA MAKING IT A REGIONAL FACILITY. THOSE COUNTIES ARE HARRISON, PENDLETON, ROBERTSON, BRACKEN, NICHOLAS, BOURBON AND SCOTT. HMH COMMUNITY IS CONSIDERED IN MOST PARTS RURAL WITH CYNTHIANA BEING ITS LARGEST TOWN IT SERVES WITH A POPULATION AROUND 7,000. THE AREA IS ALSO DESCRIBED AS A BEDROOM COMMUNITY OF LEXINGTON. THE AREA IS A FARMING COMMUNITY WITH SEVERAL STRONG INDUSTRIES BASED IN THE AREA. HMH CONSIDERS ITS SERVICE AREA POPULATION TO BE 35,000. THE DEMOGRAPHIC OF THE COMMUNITIES IS PREDOMINANTLY CAUCASIAN WITH AN AGING POPULATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SHEILA CURRANS
174245000005878058470185970000
GERALD HARPEL MD
396428000000042720400700000
NEZAR M FALLUJI
365873000000000365873000
JAMES PETTY
50520200000237705860508165000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF HARRISON KYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN616000746IssuerEIN
Date Issued2009-11-13DateIssued
Issue Price17475000IssuePrice
Description Of PurposeREFINANCE SERIES 2005 AND RETIRE THE INTEREST RATE SWAP AGREEMENTDescriptionOfPurpose
Defeased1Defeased
On Behalf Of Issuer1OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds17475000TotalProceeds
Issuance Costs From Proceeds95217IssuanceCostsFromProceeds
Working Capital Expenditures79432WorkingCapitalExpenditures
Capital Expenditures17300351CapitalExpenditures
Year Of Subst Completion2009YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed1Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part III Form990ScheduleLPartIII

Name Of Interested Business NameOfInterestedBusiness

FieldValueIRS element (for citing)
Business Name Line1BRUCE FLORENCEBusinessNameLine1
FieldValueIRS element (for citing)
Relationship With OrganizationBRUCE FLORENCE IS MARRIED TO A BOARD MEMBERRelationshipWithOrganization
Amount Of Grant15000AmountOfGrant
Type Of AssistanceGRANT TO MAYSVILLE COMMUNITY COLLEGETypeOfAssistance

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
PEGGY LAIR
PEGGY LAIR IS MARRIED TO A BOARD MEMBER77781PEGGY LAIR IS EMPLOYED AS THE CONTROLLER FOR THE HOSPITAL0
MARY BETH SLADE
MARY BETH SLADE IS SISTER TO AN OFFICER71498MARY BETH SLADE IS AN EMPLOYEE OF THE HOSPITAL0
JULIE FAIN
JULIE FAIN IS SISTER TO AN OFFICER17682JULIE FAIN IS AN EMPLOYEE OF THE HOSPITAL0
CHRYSTAL HOSKINS
CHRYSTAL HOSKINS IS THE DAUGHTER OF A HIGHEST COMPENSATED EMPLOYEE19808CHRYSTAL HOSKINS IS AN EMPLOYEE OF THE HOSPITAL0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2STEVE MOSES IS THE FATHER OF DR. STEPHEN MOSES. BOTH ARE BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11THE 990 AFTER FILING IS REVIEWED IN DETAIL AT THE FINANCE COMMITTEE MEETING WITH BOARD MEMBERS PRESENT. THEY ARE ASKED IF THEY WANT A COPY AND ARE ENCOURAGED TO PERSONALLY VISIT WITH THE CFO TO COVER ANY TOPICS NECESSARY.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, ALL APPLICABLE PERSONNEL SIGN A CONFLICT OF INTEREST STATMENT AND, WHEN NEEDED, IT IS INCORPORATED INTO POLICIES.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD CHAIR AND EXECUTIVE COMMITTEE REVIEW THE COMPENSATION ANNUALLY AFTER RECEIPT OF THE AHA ANNUAL SALARY SURVEY.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. A NEW PATIENT HANDBOOK HAS BEEN DEVELOPED FOR ALL PATIENTS AND WILL BE HANDED OUT AT OUTPATIENT ADMISSIONS OR AVAILABLE FOR USE IN PATIENT ROOMS.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 196,023.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH PARTNERSHIP LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11210 KY HWY 36EAddressLine1
CityCYNTHIANACity
StateKYState
ZIP Code41031ZIPCode
FieldValueIRS element (for citing)
EIN611348611EIN
Primary ActivityHEALTH CARE PROMOTIONPrimaryActivity
Legal Domicile StateKYLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income1511ShareOfTotalIncome
Share Of EOY Assets202ShareOfEOYAssets
Percentage Ownership0.50000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg