2023-08-11T09:41:53-05:00 2022-09-30 620713250 KRAFTCPAS PLLC 555 GREAT CIRCLE ROAD NASHVILLE TN 37228 990 2021-10-01 620988604 MACON HOSPITAL INC MACO 6156662147 305 W LOCUST STREET LAFAYETTE TN 37083 SCOTT TONGATE CFO 6156662147 2023-08-11 1 SCOTT TONGATE 999009999 FRANCES E LEAHY P00713593 6152427351 2023-08-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z THOMAS KIDD 305 W LOCUST STREET LAFAYETTE TN 37083 22029036 0 X WWW.MCGH.NET X 1975 TN THE MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST. 9 7 246 5 0 0 3433332 2982854 17004161 18934388 13363 13918 85796 97876 20536652 22029036 0 0 0 0 9870272 11272059 0 0 0 7448154 7475970 17318426 18748029 3218226 3281007 17643586 16942789 10526257 6544453 7117329 10398336 THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. 0 0 15325749 18947426 TO PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES TO CITIZENS OF MACON COUNTY, TN AND SURROUNDING COUNTIES WITHOUT REGARD TO ABILITY TO PAY, RACE, RELIGION, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, ETC. WE PROVIDE CHRONIC DISEASE MANAGEMENT EDUCATION, COMMUNITY OUTREACH AND HEALTH FAIRS TO OVER 28,110 INDIVIDUALS. PROVIDED $1,680,072 OF CHARITY CARE FOR YEAR ENDED SEPTEMBER 30, 2022. 15325749 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 57 0 1 246 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 TN X SCOTT A TONGATE 6156662147 305 W LOCUST AVE LAFAYETTE TN 37083 JENNIFER N FLIPPIN LABORTORY MANAGER 50.00 X 108068 0 3980 JULIE L BILBREY DIRECTOR OF NURSING 50.00 X 108980 0 9339 FEMI ODUNUSI M.D./DIRECTOR 2.00 X 2250 0 0 HANNA ILIA M.D./DIRECTOR 2.00 X 4920 0 0 HUGH CLARK DIRECTOR 2.00 X 1200 0 0 STANLEY CHUNN TREASURER 2.00 X X 1200 0 0 RADFORD WEST PRESIDENT 2.00 X X 1200 0 0 LINDA AUSTIN VICE PRESIDENT 2.00 X X 1100 0 0 BARBARA PAINTER DIRECTOR 2.00 X 1100 0 0 GLENN HALE DIRECTOR 2.00 X 700 0 0 MIKE WHITTEMORE DIRECTOR 2.00 X 1100 0 0 THOMAS KIDD CEO 50.00 X 0 0 0 SCOTT TONGATE CFO 50.00 X 0 0 0 231818 0 13319 2 0 0 1 QUORUM HEALTH RESOURCES LLC 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT SERVICES 788348 FISHER HEALTHCARE PO BOX 404705 ATLANTA GA 30384 MEDICAL SUPPLIES 687441 EMCARE PHYSICIAN SERVICES 7021 COLLECTION CENTER DRIVE CHICAGO IL 60693 PHYSICIAN SERVICES 657814 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 63195 ELECTRONIC HEALTH RECORD 489694 AMERISOURCEBERGEN PO BOX 978526 DALLAS TX 75397 MEDICAL SUPPLIES 262211 21 2877326 105528 2982854 NET PATIENT SERVICE REVENUE 621110 18896380 18896380 OTHER OPERATING INCOME 621110 38008 38008 18934388 13918 13918 84838 0 84838 84838 84838 ALL OTHER MISC. REVENUE 900099 13038 13038 13038 22029036 18947426 0 98756 X 14770 14770 9103776 7775980 1327796 125011 108158 16853 1395888 1170957 224931 632614 584078 48536 271587 271587 22450 22450 31485 31485 2134908 1805311 329597 106071 15813 90258 261638 84021 177617 1269512 1046818 222694 60193 28333 31860 151775 151775 938430 626378 312052 191343 127717 63626 MEDICAL SUPPLIES 1974998 1946015 28983 MISCELLANEOUS 61580 6170 55410 18748029 15325749 3422280 0 394495 602383 4927811 4973348 1837850 1494690 351539 279401 237486 225761 13508797 4902553 8257249 8606244 1637156 760962 17643586 16942789 1615691 1549078 5144693 4995375 1757723 0 2008150 0 10526257 6544453 X 7117329 10398336 7117329 10398336 17643586 16942789 3281007 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2513 2513 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE TENNESSEE HOSPITAL ASSOCIATION ARE FOR LOBBYING. 785487 785487 7530551 2696541 4834010 54930 39068 15862 3960773 1792526 2168247 1177056 374418 802638 8606244 X 22029036 0 22029036 0 22029036 18748029 0 18748029 0 18748029 PART X, LINE 2: THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE UNITED STATES FEDERAL JURISDICTION. MANAGEMENT PERFORMS AN EVALUATION OF ALL INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HOSPITAL'S INCOME TAX RETURNS TO DETERMINE WHETHER THE INCOME TAX POSITIONS MEET A "MORE LIKELY THAN NOT" STANDARD OF BEING SUSTAINED UNDER EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS PERFORMED ITS EVALUATION OF ALL INCOME TAX POSITIONS TAKEN ON ALL OPEN INCOME TAX RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AND DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2022 OR 2021. 1 1 1 X 1 X 0 1 0 1 1 1981802 1981802 0.10570 3191264 3128926 62338 0.00330 5173066 3128926 2044140 0.10900 5173066 3128926 2044140 0.10900 1 1504081 150408 4774222 4343250 430972 X 1 0 1 1 MACON HOSPITAL INC 305 W LOCUST ST LAFAYETTE TN 37083 WWW.MCGH.NET 0000000080 X X X MACON HOSPITAL INC 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTP://WWW.MCGH.NET/ABOUT-US/ X 1 21 1 HTTP://WWW.MCGH.NET/ABOUT-US/ 0 1 X 200.000000000000 200.000000000000 X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X 1 0 1 0 0 MACON HOSPITAL, INC. PART V, SECTION B, LINE 5: INPUT WAS OBTAINED FROM A LOCAL EXPERT GROUP, WHICH IS AN ADVISORY GROUP OF AT LEAST 33 LOCAL EXPERT ADVISORS. THIS GROUP WAS CONSULTED ON FINDINGS FROM SECONDARY DATA GATHERED. THEY ALSO PARTICIPATED IN A SURVEY, WHICH PROVIDED INPUT ON HEALTH NEEDS WITHIN THE COMMUNITY ALONG WITH THOUGHTS ON VULNERABLE POPULATIONS. MACON HOSPITAL, INC. PART V, SECTION B, LINE 11: MACON COUNTY HOSPITAL DETERMINED THE FOLLOWING TO BE THE TOP PRIORITIES TO ADDRESS IN THE COMMUNITY FOR THE NEXT SEVERAL YEARS:- BEHAVIORAL HEALTH WORKING TOWARDS CARE TRANSITION PROGRAM EXPLORE OPTIONS FOR IMPLEMENTING TELEPSYCHIATRY PURSUE PARTNERSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS PROMOTE AND PROVIDE EDUCATIONAL INTERVENTIONS ON BH SUICIDE PREVENTION TRAINING TO HOSPITAL EMPLOYEES PARTICIPATE IN MENTAL HEALTH MONTH EXPLORE IMPLEMENTING MEDICATION MANAGEMENT PROGRAM- AFFORDABILITY INCREASE PROMOTION OF CHARITY CARE, DISCOUNT PROGRAMS AND ASSISTANCE DURING REGISTRATION PROCESS- ACCESSIBILITY RECRUITING ADDITIONAL PHYSICIANS INTO THE COMMUNITY; TARGETING OB/GYN AND INTERNAL MEDICINE PROVIDER CONTINUING EXPANSION OF SPECIALTY CLINIC UPDATING C-ARM IMAGING SCANNER EXPLORE ADDITIONAL TRANSPORTATION OPTIONS-CHRONIC DISEASE MANAGEMENT IMPLEMENTING A CARDIAC REHABILITATION/PULMONARY REHABILITATION GRADUATE PROGRAM BLOOD PRESSURE SCREENINGS AVAILABLE FOR WALK-IN PATIENTS MACON HOSPITAL, INC. PART V, SECTION B, LINE 13B: A COPY OF THE HOSPITAL'S FAP AND FAP APPLICATION FORMS ARE AVAILABLE AT HTTPS://MCGH.NET/FOR-PATIENTS/FINANCIAL-ASSISTANCE-GUIDELINES/. PART I, LINE 7: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. PART II, COMMUNITY BUILDING ACTIVITIES: MACON COMMUNITY HOSPITAL DEDICATED STAFF VOLUNTEERS FOR NUMEROUS CAUSES PROMOTING HEALTH AND WELFARE FOR MACON COUNTY INCLUDING: RELAY FOR LIFE, MAKIN' MACON FIT FITNESS FESTIVAL, MAMMOGRAPHY SCREENINGS, BREAST CANCER AWARENESS EVENTS, SENIOR CITIZENS CENTER EDUCATION AND SCREENINGS, LOCAL RADIO WEEKLY SHOW ON HEALTH ISSUES AND HOW TO TAKE PREVENTATIVE MEASURE, MACON COUNTY CO-ORDINATED SCHOOL HEALTH PROGRAM, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE MACON COUNTY EDUCATION FOUNDATION. PART III, LINE 2: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE LINE 6. PART III, LINE 9B: THERE ARE NO COLLECTION EFFORTS TAKEN ON THE PATIENTS THAT QUALIFY FOR CHARITY CARE. THEIR ACCOUNTS ARE WRITTEN OFF SO NO MONEY IS OWED AND NO CHARGES ARE RECORDED AS INCOME. PART VI, LINE 2: MACON COMMUNITY HOSPITAL HAS CONDUCTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT AND WE ARE WORKING WITH LOCAL ORGANIZATIONS AND THE COMMUNITY TO IMPLEMENT THE ASSESSMENT. WE ARE ACTIVELY ENGAGED IN PROVIDING FOR AND IMPROVING THE HEALTH OF OUR COMMUNITY. MACON COUNTY, TENNESSEE HAS A STATISTICALLY HIGH PERCENTAGE OF THE POPULATION WITH DIABITIES AND MCH PROVIDES A DIABETES EDUCATION CENTER TO PROVIDE COOKING CLASSES, NUTRITION EDUCATION AND A QUESTION HOTLINE FOR THE COMMUNITY TO MANAGE THEIR DISEASE. MANAGEMENT OF MCH ARE ALSO LEADERS AND ORGANIZERS OF THE ANNUAL MAKIN' MACON FIT FITNESS FESTIVAL THAT PROMOTES AN ACTIVE LIFESTYLE THAT IS IN ITS 28TH YEAR. MCH STAFF WORKS WITH THE MACON COUNTY SCHOOL SYSTEM AND COORDINATED A SCHOOL HEALTH PROGRAM TO PROVIDE CLASSROOM INSTRUCTION ON NUTRITION AND FITNESS TO THE STUDENTS OF THE SCHOOL SYSTEM. MCH STAFF ARE ON THE BOARDS OF THE SENIOR CITIZEN CENTER, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE UPPER MIDDLE TN RURAL HEALTH NETWORK. THROUGH THESE ORGANIZATIONS, WE LEARN OF AND PROVIDE EDUCATION, TRAINING, SCREENINGS AND OTHER ACTIVITIES TO ASSESS AND IMPROVE THE HEALTH NEEDS OF OUR COMMUNITY. PART VI, LINE 3: THE REGISTRATION STAFF DESCRIBE AND PROVIDE LITERATURE ABOUT FINANCIAL ASSISTANCE DURING THE PATIENT INTERVIEW PROCESS. EFFORTS ARE MADE TO PUT PATIENTS IN CONTACT WITH RESOURCES AVAILABLE TO ASSIST THE PATIENT IN GETTING QUALIFIED FOR GOVERNMENT OR OTHER ASSISTANCE. APPLICATIONS FOR HOSPTIAL CHARITY CARE ARE DISTRIBUTED TO REGISTRARS, BILLING OFFICE STAFF AND A SOCIAL WORKER. POSTED NOTICES ARE OTHER SOURCES OF INFORMATION AS WELL AS LINKS ON OUR WEBSITE REGARDING OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE APPLICATION. PART VI, LINE 4: THE POPULATION FOR MACON COUNTY IS ESTIMATED TO BE 25,249.THE MEDIAN HOUSEHOLD INCOME FOR THE AREA IS $35,853, LOWER THAN THAN THE TENNESSEE MEDIAN INCOME OF $53,346.THE PORTION OF THE POPULATION LIVING IN POVERTY IN THE COUNTY IS 16.9%. PART VI, LINE 5: THE MEDICAL STAFF IS OPEN TO ANY PHYSICIAN WHO MEETS CREDENTIALING STANDARDS AND AGREES TO STANDARDS ESTABLISHED BY THE MEDICAL STAFF. VARIOUS LEADERS SERVE ON THE BOARD OF DIRECTORS ALONG WITH LEADERS OF THE PHYSICIAN COMMUNITY. SURPLUS FUNDS PROVIDE CONTINUITY OF HEALTH SERVICES DURING PERIODS OF ECONOMIC DOWNTURN AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. 0 0 0 0 0 0 0 0 0 THOMAS KIDD CEO 0 0 0 0 0 0 0 0 0 0 0 0 SCOTT TONGATE CFO 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE J, PART II THE HOSPITAL CONTRACTS THE SERVICES OF THOMAS KIDD (CEO) AND SCOTT TONGATE (CFO) WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.), AN UNRELATED ORGANIZATION. QHR WAS PAID $600,952 FOR SERVICES PROVIDED BY THESE INDIVIDUALS FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2022. MACON BANK & TRUST SEE PART V 198975 LOANS 0 PAINTER & HUDSON PLLC SEE PART V 218202 PHARMACY SERVICES 0 SCHEDULE L, PART IV MACON COMMUNITY HOSPITAL HAS A BANKING RELATIONSHIP WITH MACON BANK &TRUST. RADFORD WEST IS THE BOARD CHAIR OF MACON COMMUNITY HOSPITAL AND IS ALSO THE PRESIDENT OF MACON BANK & TRUST.THE HOSPITAL HAS A BUILDING LOAN WITH THE BANK WITH A BALANCE OF $198,975 AT 9/30/2022 AND A LINE OF CREDIT WITH A BALANCE OF $100 AT 9/30/2022. ALL TRANSACTIONS ARE CONDUCTED ON AN ARM'S LENGTH BASIS.ADDITIONALLY, BARBARA PAINTER IS A CO-OWNER OF THE COMPANY PAINTER & HUDSON, WHICH IS ONE OF THE TOP FIVE HIGHEST COMPENSATED VENDORS. SHE IS A PHARMACIST AND SHE PROVIDES PHARMACY SERVICES FOR THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL CONTRACTS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES WITH QHR (FORMERLY QUOROM HEALTH RESOURCES, INC.). UNDER TERMS OF THE AGREEMENT, QHR PROVIDES THE SERVICES OF A CEO, CFO, AND ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES CONSISTENT WITH THE POLICIES AND DIRECTIVES DICTATED BY THE BOARD OF DIRECTORS. FOR FISCAL YEAR SEPTEMBER 30, 2022 MACON COMMUNITY HOSPITAL PAID QHR $347,717 FOR THE SERVICES OF THOMAS KIDD (CEO), AND $253,235 FOR THE SERVICES OF SCOTT TONGATE (CFO). PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THE CEO AND CFO. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE ITS FORM 990. ONCE THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT, THE FINAL FORM IS PROVIDED TO A BOARD MEMBER DESIGNATED BY THE BOARD OF DIRECTORS TO REVIEW. QUESTIONS AND COMMENTS RAISED DURING THE REVIEW REGARDING THE FINAL FORM 990 ARE ADDRESSED PRIOR TO FILING. ONCE APPROVED, THE FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES OF THE HOSPITAL ARE COVERED AND REVIEWED BY THE COMPLIANCE OFFICER. ANY EMPLOYEES HAVING A CONFLICT OF INTEREST ARE NOT ALLOWED TO PARTICIPATE IN THE DECISION MAKING REGARDING ANY ACTIVITY THAT WOULD BE VIEWED AS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 IN 2020, QHR CONDUCTED A REVIEW THAT SHOWS THE MINIMUM, MEDIAN, AND MAXIMUM SALARY FOR THE SAME POSITION AT SIMILAR ORGANIZATIONS IN SIZE AND VOLUME. THE BOARD THEN TAKES THIS INFORMATION AND SETS THE SALARY FOR THE CEO AND CFO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE STORED IN ADMINISTRATION AND AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,805,311. MANAGEMENT AND GENERAL EXPENSES 329,597. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,134,908. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.