THE COMMUNITY HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- THE COMMUNITY HOSPITAL INC (EIN 61-0445841)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-07-25
- IRS object ID
- 201222079349300802
- Schema version
- 2010v3.7
- 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 D
- Schedule H
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-07-25T15:34:05-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BUCKLES TRAVIS VANMETER & HART PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4069 | AddressLine1 |
| City | LEITCHFIELD | City |
| State | KY | State |
| ZIP Code | 427554069 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610445841 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MUHLENBERG COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MUHL | NameControl |
| Phone | 2703388000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 HOPKINSVILLE ST | AddressLine1 |
| City | GREENVILLE | City |
| State | KY | State |
| ZIP Code | 423451124 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN COUNTZLER | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 2703388000 | Phone |
| Date Signed | 2012-07-11 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRADLEY K TRAVIS | Name |
| Phone | 2702595604 | Phone |
| Date Prepared | 2012-07-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN COUNTZLER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 HOPKINSVILLE ST | AddressLine1 |
| City | GREENVILLE | City |
| State | KY | State |
| ZIP Code | 423450387 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 88283446 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MCHKY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1938 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | PATIENT CARE - HEALTHCARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 573 | TotalNbrEmployees |
| Total Nbr Volunteers | 35 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 625896 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 894460 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 83199938 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 87153565 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 107080 | InvestmentIncomePriorYear |
| Investment Income Current Year | 111548 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 627943 | OtherRevenuePriorYear |
| Other Revenue Current Year | 123873 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 84560857 | TotalRevenuePriorYear |
| Total Revenue Current Year | 88283446 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 19904503 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19447212 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 64720337 | OtherExpensePriorYear |
| Other Expenses Current Year | 68746026 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 84624840 | TotalExpensesPriorYear |
| Total Expenses Current Year | 88193238 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -63983 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 90208 | RevenuesLessExpensesCY |
| Total Assets BOY | 23001387 | TotalAssetsBOY |
| Total Assets EOY | 21219725 | TotalAssetsEOY |
| Total Liabilities BOY | 4502610 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2630740 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18498777 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 18588985 | NetAssetsOrFundBalancesEOY |
| Mission Description | PATIENT CARE - HEALTHCARE SERVICES | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 79899966 | Expense |
| Description | HEALTH CARE DELIVERY & MANAGEMENT: THE HOSPITAL OPERATES A 90 BED ACUTE CARE AND A 45 BED SKILLED NURSING FACILITY WITH RELATED OUTPATIENT AND ANCILLARY SERVICES, INCLUDING A 24 HOUR EMERGENCY DEPARTMENT. MUHLENBERG COMMUNITY HOSPITAL (MCH) PARTICIPATES WITH MEDICARE, MEDICAID AND INDIGENT CARE PROGRAMS IN THE STATE OF KENTUCKY. THE HOSPITAL PROMOTES AND FURTHERS THE HEALTH AND GENERAL STANDARDS OF LIVING IN OUR COMMUNITY. THE ACTIVITY OF RENDERING HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, ACCOMPLISHES THE HOSPITAL'S EXEMPT PURPOSE. | Description |
| Total Program Service Expense | 79899966 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 48 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 573 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN COUNTZLER | NamePerson |
| Telephone Number | 2703388275 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 HOPKINSVILLE ST | AddressLine1 |
| City | GREENVILLE | City |
| State | KY | State |
| ZIP Code | 423450387 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| CHARLES R LEWIS | ||||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | |||
| DR MARY W BROWN | ||||||||
| SECRETARY/TR | 2.00 | X | 0 | 0 | 0 | |||
| DR WILLARD KEITH | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DR FREDDIE MAYES | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DAVID JERNIGAN | ||||||||
| VICE CHAIRMA | 2.00 | X | 0 | 0 | 0 | |||
| TAMMY S BREWER | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| W LEE FAUNTLEROY | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DR HEATH SUTTON | ||||||||
| MEDICAL STAF | 2.00 | X | 0 | 0 | 0 | |||
| KATHLEEN MITCHELL | ||||||||
| CNO | 40.00 | 22646 | 0 | 0 | X | |||
| JOHN COUNTZLER | ||||||||
| CEO | 40.00 | 0 | 0 | 0 | X | |||
| JOSEPH SWAB | ||||||||
| CFO | 40.00 | 0 | 0 | 0 | X | |||
| VINCENT GENOVESE | ||||||||
| MD | 40.00 | 392580 | 0 | 6125 | X | |||
| DENNIS KNOEPFLER | ||||||||
| MD | 40.00 | 346658 | 0 | 6125 | X | |||
| MARTIN LIKINS | ||||||||
| RPH | 40.00 | 116025 | 0 | 0 | X | |||
| ANN MURPHY | ||||||||
| RPH | 40.00 | 107855 | 0 | 1088 | X | |||
| JOHN CLEMENTS | ||||||||
| CFO | 40.00 | 133495 | 0 | 3337 | X | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1119259 | TotalReportableCompFromOrg |
| Total Other Compensation | 16675 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ALLIANT MANAGEMENT SERVICES | |||||
| 2650 EASTPOINT PKWY SUITE 310 | LOUISVILLE | KY | 40223 | MANAGEMENT SVCS | 429909 |
| GWC SYSTEMS | |||||
| 1232 STATE ROUTE 973 | GREENVILLE | KY | 42345 | IT CONSULTANT | 154658 |
| SODEXO | |||||
| 9801 WASHINGTON BLVD MS31 | GAITHERSBERG | MD | 20878 | DIETARY/CAFETER | 146157 |
| KENTUCKY EMERGENCY ROOM PHYSICIANS | |||||
| 320 DAWN DRIVE | GREENVILLE | KY | 42345 | ER PHYSICIANS | 138325 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 101071 | ATLANTA | GA | 30374 | LABORATORY SVCS | 130982 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Government Grants | 422217 | GovernmentGrants |
| All Other Contributions | 472243 | AllOtherContributions |
| Noncash Contributions | 417000 | NoncashContributions |
| Total Contributions | 894460 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROGRAM SERVICE REVENUE | Description |
| Total Revenue Column | 87153565 | TotalRevenueColumn |
| Related Or Exempt Function Income | 87153565 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 87153565 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 111548 | TotalRevenueColumn |
| Related Or Exempt Function Income | 111548 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 17025 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 17025 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17025 | TotalRevenueColumn |
| Exclusion | $17,025 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|
| DIETARY/ CAFETERIA | 132413 | $132,413 |
| MUHLENBERG MEDICAL PROPERTIES | 48331 | $48,331 |
| MUHLENBERG SURGERY CENTER REV | -11706 | -$11,706 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -62190 | TotalRevenueColumn |
| Related Or Exempt Function Income | -62190 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 106848 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 88283446 | TotalRevenueColumn |
| Related Or Exempt Function Income | 87202923 | RelatedOrExemptFunctionIncome |
| Exclusion | $186,063 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14957130 | Total |
| Program Services | 11520539 | ProgramServices |
| Management And General | 3436591 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99891 | Total |
| Program Services | 74918 | ProgramServices |
| Management And General | 24973 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3257686 | Total |
| Program Services | 2443264 | ProgramServices |
| Management And General | 814422 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1132505 | Total |
| Program Services | 861444 | ProgramServices |
| Management And General | 271061 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 407773 | Total |
| Management And General | 407773 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124972 | Total |
| Management And General | 124972 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31640 | Total |
| Management And General | 31640 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1553927 | Total |
| Program Services | 587649 | ProgramServices |
| Management And General | 966278 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 184567 | Total |
| Program Services | 27525 | ProgramServices |
| Management And General | 157042 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36475 | Total |
| Program Services | 5868 | ProgramServices |
| Management And General | 30607 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89682 | Total |
| Management And General | 89682 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 721294 | Total |
| Program Services | 468841 | ProgramServices |
| Management And General | 252453 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162782 | Total |
| Program Services | 153771 | ProgramServices |
| Management And General | 9011 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70038 | Total |
| Program Services | 44902 | ProgramServices |
| Management And General | 25136 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1338796 | Total |
| Program Services | 870217 | ProgramServices |
| Management And General | 468579 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 308303 | Total |
| Program Services | 308303 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| CONTRACTUALS / BAD DEBT - | 54494035 | 54494035 |
| SUPPLIES - P/S | 4917837 | 4917837 |
| PHYSICIAN FEES - P/S | 1429763 | 1429763 |
| PROVIDER & OTHER TAXES - | 853611 | 853611 |
| EQUIPMENT RENTAL - P/S | 785809 | 785809 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1234722 | Total |
| Program Services | 51670 | ProgramServices |
| Management And General | 1183052 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88193238 | Total |
| Program Services | 79899966 | ProgramServices |
| Management And General | 8293272 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1500 | BOY |
| EOY | 1825 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 885726 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5930735 | BOY |
| EOY | 6486848 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1138310 | BOY |
| EOY | 1186162 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 248111 | BOY |
| EOY | 355788 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 36840622 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 28874042 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8386454 | BOY |
| EOY | 7966580 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6397483 | BOY |
| EOY | 4515213 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 707309 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13068 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23001387 | BOY |
| EOY | 21219725 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2757471 | BOY |
| EOY | 2578740 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1693139 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52000 | BOY |
| EOY | 52000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4502610 | BOY |
| EOY | 2630740 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18498777 | BOY |
| EOY | 18588985 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18498777 | BOY |
| EOY | 18588985 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23001387 | BOY |
| EOY | 21219725 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 90208 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | 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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11466574 | OtherCostOrOtherBasis |
| Depreciation | 8351485 | Depreciation |
| Book Value | 3115089 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23647699 | OtherCostOrOtherBasis |
| Depreciation | 20108831 | Depreciation |
| Book Value | 3538868 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1726349 | OtherCostOrOtherBasis |
| Depreciation | 413726 | Depreciation |
| Book Value | 1312623 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7966580 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 633769 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSETS LIMITED AS TO USE (CASH & EQU | Description |
| Book Value | 3881444 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 4515213 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NOTE PAYABLE - MCH FOUNDATION | Description |
| Amount | $52,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 52000 | TotalOfAmounts |
| Total Revenue | 88283446 | TotalRevenue |
| Total Expenses | 88193238 | TotalExpenses |
| Excess Or Deficit For Year | 90208 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 90208 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 88283446 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 88283446 | RevenueSubtotal |
| Total Revenue Per Form990 | 88283446 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 88193238 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 88193238 | ExpensesSubtotal |
| Total Expenses Per Form990 | 88193238 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1294751 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 258768 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1035983 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6265070 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3941145 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2323925 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02640 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7559821 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4199913 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3359908 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03810 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 154349 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 154349 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 154349 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 154349 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7714170 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4199913 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3514257 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03980 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,724,714 | BadDebtExpenseAmount |
| Amount Attributable To | 862357 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12903330 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 13907862 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1004532 | 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 | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLIANT MANAGEMENT S | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | PROVIDES CEO, PURCHASING AGREEMENT, EDUC | DescriptionEntPrimaryActivity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | MUHLENBERG COMMUNITY HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 HOPKINSVILLE ST | AddressLine1 |
| City | GREENVILLE | City |
| State | KY | State |
| ZIP Code | 423450387 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | HOME HEALTH-EMS-SKILLED NURSIN | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MUHLENBERG COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0 | FPGFreePercent |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | false | IncludesPublicityMeasures |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| COMMUNITY BUILDING ACTIVITIES | PART II | MUHLENBERG COMMUNITY HOSPITAL HAS AN ONGOING COMMITMENT TO ITS COMMUNITY DUE TO MUHLENBERG COUNTYS HIGH RATE OF JOBLESSNESS THE HOSPITAL DECIDED IT WAS IN THE COMMUNITYS BEST INTEREST TO SUPPORT LOCAL VENDORS WHEN POSSIBLE AND TO SUPPORT COMMUNITY EFFORTS TO BRING NEW INDUSTRY TO THE REGION THE HOSPITAL ALSO SUPPORTS LOCAL DISASTER PREPAREDNESS ACTIVITIES |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE TOTAL BAD DEBT EXPENSE AT COST REPRESENTS THE TOTAL AMOUNT EXPECTED TO BE COLLECTED BUT DEEMED UNCOLLECTIBLE BASED ON THE COMMUNITYS DEMOGRAPHICS INCOME LEVEL INDIVIDUAL ASSETS AND HEALTH COVERAGE 50 WAS DETERMINED TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITALS PATIENT FINANCIAL ASSISTANCE PROGRAM FINANCIAL STATEMENT FOOTNOTE PATIENT ACCOUNTS RECEIVABLE ARE ORDINARILY DUE THIRTY DAYS AFTER THE ISSUANCE OF THE INVOICE AT THE EXPIRATION OF THE THIRTY DAYS IF NO RESPONSE IS RECEIVED FROM THE PATIENT A STATEMENT IS GENERATED AND FORWARDED TO AN OUTSOURCE AGENCY HEALTH CLAIMS MANAGEMENT HCM HCM WILL GENERATE AND PROCESS A TOTAL OF THREE STATEMENTS TO COLLECT THE AMOUNT DUE ADDITIONAL STATEMENTS COULD BE GENERATED IF A PAYMENT ARRANGEMENT HAS BEEN APPROVED IF THE HOSPITAL RECEIVES NO PAYMENT OR COMMUNICATION TO ARRANGE PAYMENT THE ACCOUNT IS SENT TO COLLECTION AND RECOGNIZED AS BAD DEBT AT THAT TIME |
| MEDICARE EXPLANATION | PART III LINE 8 | THE TOTAL MEDICARE ALLOWABLE COSTS OF CARE REPRESENTS THE AMOUNT REPORTED IN THE HOSPITALS MEDICARE COST REPORT MUHLENBERG COMMUNITY HOSPITALS MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT DUE TO THE COMMUNITY IT SERVES MEDICARE REPRESENTS 44 OF THE HOSPITALS PAYOR MIX WITH MEDICARE REPRESENTING SUCH A LARGE PORTION OF THE PAYOR MIX THE HOSPITAL DEPENDS ON MEDICARE PAYMENTS IF MEDICARE PAYS LESS THAN COST IT IS DETRIMENTAL TO THE HOSPITAL AND THEREFORE SHOULD BE CONSIDERED AS COMMUNITY BENEFIT |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | PATIENT ACCOUNTS THAT ARE APPROVED FOR CHARITY ARE WRITTEN OFF TO OUR HOSPITAL CHARITY ADJUSTMENT THE PATIENT IS NOTIFIED OF CHARITY APPROVAL BY MAIL NO FURTHER STATEMENTS OF ACCOUNT OR OTHER CORRESPONDENCE ARE ISSUED |
| NEEDS ASSESSMENT | PART VI | MUHLENBERG COMMUNITY HOSPITAL ASSESSES THE COMMUNITYS HEALTH CARE NEEDS BY OBTAINING INFORMATION FROM A VARIETY OF SOURCES INCLUDING A DEMOGRAPHIC DATABASES B LOCAL AND REGIONAL HEALTH DEPARTMENTS AND RELATED DATABASES C KENTUCKY HOSPITAL ASSOCIATION REPORTS AND DATABASES D MARKET ANALYSIS E FEEDBACK FROM PHYSICIANS AND OTHER INTERESTED COMMUNITY GROUPS F HOSPITALGENERATED REPORTS ON UTILIZATION OF SERVICES G BOARD OF DIRECTORS MADE UP OF LOCAL COUNTY RESIDENTS |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | MUHLENBERG COMMUNITY HOSPITAL REACHES OUT TO EDUCATE PATIENTS ABOUT THE PATIENT FINANCIAL ASSISTANCE PROGRAM THE PATIENT FINANCIAL ASSISTANCE PROGRAM INFORMATION IS INCLUDED IN THE PATIENT INFORMATION HANDBOOK THAT IS GIVEN TO EVERY PATIENT AT THE TIME OF REGISTRATION THE ADMISSION CONSENT FORM ALSO INCLUDES AN ACKNOWLEDGEMENT BY THE PATIENT THAT THEY WERE GIVEN THE HANDBOOK IN ADDITION SELFPAY PATIENTS ARE INFORMED OF FEDERAL STATE AND LOCAL GOVERNMENTAL ASSISTANCE PROGRAMS WITHIN 24 HOURS OF ADMISSION SELFPAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR AND INFORMED OF THE AVAILABLE PROGRAMS |
| COMMUNITY INFORMATION | PART VI | THE PRIMARY SERVICE AREA FOR MUHLENBERG COMMUNITY HOSPITAL IS MUHLENBERG COUNTY KENTUCKY POPULATION OF 31499 IN 2010 LOCATED 115 MILES NORTH OF NASHVILLE TN 125 MILES SOUTHWEST OF LOUISVILLE KY AND 70 MILES SOUTH OF EVANSVILLE IN THE HOSPITALS SECONDARY SERVICE AREA INCLUDES PARTS OF HOPKINS TODD OHIO MCLEAN BUTLER LOGAN AND CHRISTIAN COUNTIES WHICH ARE THE SURROUNDING COUNTIES THE ESTIMATED PERCENTAGE OF PEOPLE LIVING BELOW THE POVERTY LEVEL AS DETERMINED BY THE US CENSUS BUREAU 2007 IS 20 FROM MUHLENBERG COUNTY AND AN AVERAGE OF 169 OF THE SECONDARY SERVICE AREA THE AREA IS MOSTLY RURAL WITH A HIGHER PERCENTAGE OF PERSONS OVER THE AGE OF 65 AND A SIGNIFICANTLY LOWER MEDIAN HOUSEHOLD INCOME THAN FOR ALL OF KENTUCKY THE AVERAGE UNEMPLOYMENT RATE IN MUHLENBERG COUNTY FOR CALENDAR YEAR 2010 WAS 11 COMPARED TO THE STATE AVERAGE OF 105 |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | MUHLENBERG COMMUNITY HOSPITAL AND ITS EMPLOYEES HAVE A RICH HISTORY OF PLANNING ANDOR SPONSORING EVENTS DESIGNED TO EDUCATE THE COMMUNITY ON HEALTHY LIVING AND WELLNESS FACTORS EVENTS DURING FISCAL YEAR ENDING 93011 INCLUDED HEALTH FAIRS AND SCREENINGS FOR THE COMMUNITY AND PRIVATE ORGANIZATIONS MUHLENBERG COMMUNITY HOSPITAL ADHERES TO THE FOLLOWING IRS EXEMPTION REQUIREMENTS A ACCEPT AND TREAT MEDICARE AND MEDICAID PATIENTS B EMERGENCY DEPARTMENT OPEN TO ALL EMERGENT CASES REGARDLESS OF ABILITY TO PAY C OPEN MEDICAL STAFF THAT ALLOWS CREDENTIALED PHYSICIANS TO PRACTICE AT FACILITY D OPERATE UNDER COMMUNITY BOARDS CONTROL IT IS THE MISSION AND ONGOING GOAL OF THE LEADERSHIP AND EMPLOYEES OF MUHLENBERG COMMUNITY HOSPITAL TO DO THE BEST JOB POSSIBLE TREATING THE SICK AND INJURED ADDRESSING COMMUNITY WELLNESS NEEDS AND PROMOTING HEALTHY LIVING AT EVERY OPPORTUNITY THROUGH OUR MANY COMMUNITY BENEFIT ACTIVITIES OUR CHARITY CARE PROGRAM AND OUR ACCEPTANCE OF PATIENTS COVERED BY FEDERAL AND STATE PROGRAMS MUHLENBERG COMMUNITY HOSPITAL MAKES A POSITIVE DIFFERENCE IN THE QUALITY OF LIFE IN THE COMMUNITY WE SERVE |
| MUHLENBERG COMMUNITY HOSPITAL INC LINE NUMBER 1 PART V LINE 19D | PART V LINE 19D | THE HOSPITAL FOLLOWS THE ESTABLISHED POLICY FOR FINANCIAL ASSISTANCE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|
| VINCENT GENOVESE | ||
| 392580 | 6125 | 398705 |
| DENNIS KNOEPFLER | ||
| 346658 | 6125 | 352783 |
| JOHN CLEMENTS | ||
| 133495 | 3337 | 136832 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| KENTUCKY EMERGENCY ROOM PHYSICIANS | |||
| W KEITH - OWNER | 138325 | ER PHYSICIAN SERVICE | false |
| CLARENCE BREWERFIRST SECURITY BANK | |||
| FAMILY MEMBER O | 250000 | CERTIFICATE OF DEPOS | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE L PART V | ReturnReference |
| Explanation | 1 THE TRANSACTIONS WITH KENTUCKY EMERGENCY ROOM PHYSICIANS KERP IS FOR EMERGENCY DEPARTMENT AND HOSPITALIST COVERAGE THESE PAYMENTS REPRESENT TRANSACTIONS BASED ON FAIR MARKET VALUE OF SERVICES PROVIDED THE KERP TRANSACTIONS ARE REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES 2THE CERTIFICATE OF DEPOSIT WAS OPENED WITH FIRST SECURITY BANK BECAUSE THEY OFFERED HIGHER INTEREST RATES AT THE TIME BASED UPON THE AMOUNT AND TERMS | Explanation |
Schedule M IRS990ScheduleM
Securities Prtnrshp Trust Intrsts SecuritiesPrtnrshpTrustIntrsts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 417000 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS | FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS PROVIDE NON-CLINICAL SERVICES, INCLUDING OFFICE ASSISTANCE, STAFFING THE INFORMATION DESK, AND OPERATING THE GIFT SHOP. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL IS EMPLOYED BY ALLIANT MANAGEMENT SERVICES AND IS RESPONSIBLE FOR CONTROLLING MANAGEMENT DUTIES. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE CEO WILL REVIEW THE 990 WITH THE BOARD OF DIRECTORS BEFORE IT IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ALL MANAGEMENT EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO UPDATE AND SIGN OFF ON A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | ALLIANT MANAGEMENT SERVICES EMPLOYS THE HOSPITAL'S CEO AND CFO. THEY PERFORM COMPARABILITY STUDIES AND RECOMMEND SALARY PACKAGES TO THE HOSPITAL'S PERSONNEL COMMITTEE. THE SALARY PACKAGES ARE REVIEWED AND APPROVED BY THE HOSPITAL'S PERSONNEL COMMITTEE. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPARABILITY DATA IS REVIEWED REGARDING THE CEO AND CFO'S SALARY PACKAGES. THE SALARY PACKAGES ARE REVIEWED AND APPROVED BY THE HOSPITAL'S FINANCE COMMITTEE ON AN ANNUAL BASIS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MUHLENBERG COMMUNITY HOSPITAL F | BusinessNameLine1 |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 HOPKINSVILLE ST | AddressLine1 |
| City | GREENVILLE | City |
| State | KY | State |
| ZIP Code | 423450387 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261600611 | EIN |
| Primary Activities | FUNDRAISIN | PrimaryActivities |
| Legal Domicile State | KY | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 9 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|
| MUHLENBERG SURGERY CENTER LLC | ||||||||||
| 1008 MEDICAL CENTER DRIVE | POWDERLY | KY | 42367 | 611398071 | SURGERY CE | KY | N/A | false | false | 1.00000 |
| MUHLENBERG MEDICAL PROPERTIES IV LL | ||||||||||
| 1010 MEDICAL CENTER DRIVE | POWDERLY | KY | 42367 | 010571762 | LESSOR OF | KY | N/A | false | false | 0.49000 |
| GENESIS HEALTH ALLIANCE LLC | ||||||||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47714 | 208223181 | PURCHASING | IN | N/A | false | false | 0.04170 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |