2011-08-11T08:30:44-05:00 2010-09-30 BUCKLES TRAVIS VANMETER & HART PLLC PO BOX 4069 LEITCHFIELD KY 427554069 990 2009-10-01 610445841 MUHLENBERG COMMUNITY HOSPITAL INC MUHL 2703388000 440 HOPKINSVILLE ST GREENVILLE KY 423451124 JOHN COUNTZLER 2703388000 2011-07-13 true BRADLEY K TRAVIS 2702595604 2011-08-10 2009 2016-02-24 21:20:13Z JOHN COUNTZLER 440 HOPKINSVILLE ST GREENVILLE KY 423450387 84560857 false X WWW.MCHKY.ORG X 1938 KY PATIENT CARE - HEALTHCARE SERVICES 9 7 585 35 0 365759 625896 83799353 83199938 -78382 107080 646828 627943 84733558 84560857 0 0 18794370 19904503 0 0 65420643 64720337 84215013 84624840 518545 -63983 25166097 23170098 6434626 4502610 18731471 18667488 PATIENT CARE - HEALTHCARE SERVICES false false 76307570 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. 76307570 true true false false false false false false false true true false false false false false false false false false true false false true true false false false false false false false true true false true false false false false true false false false true 41 0 true 585 true false false false false false false false false false false false 9 7 false true false false false false false true true false false true true true true true true true true true false X JOHN COUNTZLER 2703388275 440 HOPKINSVILLE ST GREENVILLE KY 423450387 CHARLES R LEWIS 2.00 X 0 0 0 DR MARY W BROWN 2.00 X 0 0 0 DR WILLARD KEITH 2.00 X 0 0 0 DR FREDDIE MAYES 2.00 X 0 0 0 DAVID JERNIGAN 2.00 X 0 0 0 JAMES E TARDIO 2.00 X 0 0 0 TAMMY S BREWER 2.00 X 0 0 0 W LEE FAUNTLEROY 2.00 X 0 0 0 DR BRIAN CHANEY 2.00 X 0 0 0 JOHN CLEMENTS 40.00 X 132838 0 3381 TRACY BYERS 40.00 X 0 0 0 VINCENT GENOVESE 40.00 X 393102 0 6204 DENNIS KNOEPFLER 40.00 X 232484 0 0 ANN MURPHY 40.00 X 106738 0 1117 MARGARET ROBINSON 40.00 X X 102811 0 0 967973 10702 5 true true false ALLIANT MANAGEMENT SERVICES 2650 EASTPOINT PKWY SUITE 310 LOUISVILLE KY 40223 MANAGEMENT SVCS 427827 QUEST DIAGNOSTICS PO BOX 740736 ATLANTA GA 303740736 LABORATORY SVCS 123208 GOULD TURNER GROUP P C 4400 HARDING ROAD STE 1000 NASHVILLE TN 37205 ARCHITECT SVCS 113474 3 423896 202000 54000 625896 PROGRAM SERVICE REVENUE 83199938 83199938 83199938 107080 107080 25025 25025 25025 25025 UNREALIZED GAIN ON INVESTMENT 226185 226185 MUHLENBERG SURGERY CENTER 211449 211449 DIETARY/CAFETERIA 127792 127792 37492 37492 602918 84560857 83533203 401758 14534215 11065019 3469196 197899 148424 49475 4059150 3044362 1014788 1113239 835383 277856 428958 428958 65897 65897 20830 20830 1485038 572486 912552 101247 8280 92967 41786 8032 33754 88580 88580 665996 432897 233099 136263 127880 8383 88835 37117 51718 49901 49901 1573150 1022547 550603 245634 245634 CONTRACTUALS/ BAD DEBTS 50898815 50898815 SUPPLIES 5447689 4936519 511170 EQUIPMENT RENTAL AND MAIN 1263059 795681 467378 PHYSICIAN FEES 1199241 1199241 PROVIDER & OTHER TAXES 853289 853289 66129 26063 40066 84624840 76307570 8317270 0 1500 1500 1550371 885726 6919633 5930735 1078622 1138310 271658 248111 36110026 27723572 8868365 8386454 6278306 6566194 197642 13068 25166097 23170098 3032928 2757471 3401698 1745139 6434626 4502610 X 18731471 18667488 18731471 18667488 25166097 23170098 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 11466574 7308677 4157897 23419952 20015690 3404262 1223500 399205 824295 8386454 828665 C ASSETS LIMITED AS TO USE (CASH & EQU 5737529 F 6566194 84560857 84624840 -63983 -63983 84560857 84560857 84560857 84624840 84624840 84624840 true true true X false true true true false true true 791355 224670 566685 0.00670 7218924 4308404 2910520 0.03440 8010279 4533074 3477205 0.04110 152563 152563 0.00180 152563 152563 0.00180 8162842 4533074 3629768 0.04290 true 1692859 846429 12048115 13464699 -1416584 X true true ALLIANT MANAGEMENT S PROVIDES CEO, PURCHASING AGREEMENT, EDUC MUHLENBERG COMMUNITY HOSPITAL INC

440 HOPKINSVILLE ST GREENVILLE KY 423450387

X THE TOTAL BAD DEBT EXPENSE AT COST REPRESENTS THE TOTAL AMOUNT EXPECTED TO BE COLLECTED, BUT DEEMED UNCOLLECTIBLE. BASED ON THE COMMUNITY'S DEMOGRAPHICS, INCOME LEVEL, INDIVIDUAL ASSETS, AND HEALTH COVERAGE, 50% WAS DETERMINED TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE PRGRAM. 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. THE TOTAL MEDICARE ALLOWABLE COSTS OF CARE REPRESENTS THE AMOUNT REPORTED IN THE HOSPITAL'S MEDICARE COST REPORT. MUHLENBERG COMMUNITY HOSPITAL'S MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT DUE TO THE COMMUNITY IT SERVES. MEDICARE REPRESENTS 43% OF THE HOSPITAL'S 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. 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. MUHLENBERG COMMUNITY HOSPITAL ASSESSES THE COMMUNITY'S 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. HOSPITAL-GENERATED REPORTS ON UTILIZATION OF SERVICES G. BOARD OF DIRECTORS MADE UP OF LOCAL, COUNTY RESIDENTS 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, SELF-PAY PATIENTS ARE INFORMED OF FEDERAL, STATE AND LOCAL GOVERNMENTAL ASSISTANCE PROGRAMS. WITHIN 24 HOURS OF ADMISSION, SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR AND INFORMED OF THE AVAILABLE PROGRAMS. THE PRIMARY SERVICE AREA FOR MUHLENBERG COMMUNITY HOSPITAL IS MUHLENBERG COUNTY, KENTUCKY (POPULATION OF 31,499 IN 2010) LOCATED 115 MILES NORTH OF NASHVILLE, TN; 125 MILES SOUTHWEST OF LOUISVILLE, KY AND 70 MILES SOUTH OF EVANSVILLE, IN. THE HOSPITAL'S 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 U.S. CENSUS BUREAU (2007) IS 20% FROM MUHLENBERG COUNTY AND AN AVERAGE OF 16.9% 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 10.5%. MUHLENBERG COMMUNITY HOSPITAL HAS AN ONGOING COMMITMENT TO ITS COMMUNITY. DUE TO MUHLENBERG COUNTY'S HIGH RATE OF JOBLESSNESS, THE HOSPITAL DECIDED IT WAS IN THE COMMUNITY'S 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. MUHLENBERG COMMUNITY HOSPITAL AND ITS EMPLOYEES HAVE A RICH HISTORY OF PLANNING AND/OR SPONSORING EVENTS DESIGNED TO EDUCATE THE COMMUNITY ON HEALTHY LIVING AND WELLNESS FACTORS. EVENTS DURING FISCAL YEAR ENDING 9/30/10 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 BOARD'S 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. X X false false false false false false false false false VINCENT GENOVESE 393102 6204 399306 DENNIS KNOEPFLER 232484 232484 MARGARET ROBINSON 102811 102811 COUNTY OF MUHLENBERG KENTUCKY 616000791 2006-08-16 7563025 REFUND 1988 & 1996 B false false 1745139 4130236 78250 2006 true true true true false false false false false false true true true OLD NAT'L BANK 5.0 false false false KENTUCKY EMERGENCY ROOM PHYSICIANS W KEITH - OWNER 138445 ER PHYSICIAN SERVICE false CLARENCE BREWERFIRST SECURITY BANK FAMILY MEMBER O 250000 CERTIFICATE OF DEPOS false X 1 54000 false false false 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 11 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. THEY PERFORM COMPARABILITY STUDIES AND RECOMMEND A SALARY PACKAGE TO THE HOSPITAL'S PERSONNEL COMMITTEE. THE SALARY PACKAGE IS 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 CFO'S SALARY PACKAGE. THE SALARY PACKAGE IS 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. THE MUHLENBERG COMMUNITY HOSPITAL F FOUNDATION INC 440 HOPKINSVILLE ST GREENVILLE KY 423450387 261600611 FUNDRAISIN KY 501 9 MCH MUHLENBERG SURGERY CENTER LLC 1008 MEDICAL CENTER DRIVE POWDERLY KY 42367 611398071 SURGERY CE KY N/A false false MUHLENBERG MEDICAL PROPERTIES IV LL 1010 MEDICAL CENTER DRIVE POWDERLY KY 42367 010571762 LESSOR OF KY N/A false false GENESIS HEALTH ALLIANCE LLC 3700 WASHINGTON AVENUE EVANSVILLE IN 47714 208223181 PURCHASING IN N/A false false false false false false false false false false false false false false false false false true false false