2021-04-13T08:01:36-05:00 2020-06-30 621046406 JOHNSON HICKEY & MURCHISON PC 2215 OLAN MILLS DRIVE CHATTANOOGA TN 37421 990 2019-07-01 621220402 SISKIN HOSPITAL FOR PHYSICAL REHABILITATION INC SISK 4236341200 1 SISKIN PLAZA CHATTANOOGA TN 37403 CAROL ARNHART CFO 4236341200 2021-04-12 1 BARRY R HUGGINS P01425228 4237560052 2021-04-12 2019 2022-09-23 18:48:47Z MATTHEW GIBSON ONE SISKIN PLAZA CHATTANOOGA TN 37403 52512970 0 X WWW.SISKINREHAB.ORG X 1984 TN REHABILITATION HEALTH CARE 19 18 748 0 42121 41121 308845 868100 47990782 46686399 692772 -107036 1360359 1104597 50352758 48552060 0 43530 0 0 31923172 31482316 0 0 56768 16770519 15411964 48693691 46937810 1659067 1614250 122104578 126934150 39488757 40573993 82615821 86360157 X SISKIN HOSPITAL FOR PHYSICAL REHABILITATION IS COMMITTED TO PROVIDING A WIDE RANGE OF HIGH QUALITY PHYSICAL REHABILITATION SERVICES WHERE POSITIVE OUTCOMES ARE ACHIEVED THAT BENEFIT THE INDIVIDUAL SERVED, AS WELL AS THE COMMUNITY AT LARGE. 0 0 16515537 22418131 DURING THE FYE 06/30/20 THE HOSPITAL PROVIDED QUALITY NURSING SERVICES FOR ALL CATEGORIES OF PATIENTS. 26,260 INPATIENT REHABILITATION SERVICE DAYS AND 12,656 SUBACUTE REHAB SERVICE DAYS WERE PROVIDED DURING THIS PERIOD. 7423008 10075964 THE HOSPITAL PROVIDED 136,822 INPATIENT UNITS AND 97,762 OUTPATIENT UNITS OF PHYSICAL THERAPY SERVICE DURING FYE 06/30/20. 3355420 4554635 THE HOSPITAL PROVIDED 74,380 INPATIENT UNITS AND 22,010 OUTPATIENT UNITS OF OCCUPATIONAL THERAPY SERVICE DURING THE FYE 06/30/20. 7415376 43530 10065607 ALL OTHER ACHIEVEMENTS - SERVICES PROVIDED BY THE HOSPITAL INCLUDING SPEECH THERAPY AND OTHER SERVICES. 7415376 43530 10065607 34709341 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 53 0 1 748 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TN X CAROL ARNHART 4236341200 ONE SISKIN PLAZA CHATTANOOGA TN 37403 TRUDY HARPER CHAIR 1.00 X X 0 0 0 ROSE E DECOSIMO CPA CGMA DIRECTOR 1.00 X 0 0 0 MICHAEL FILLAUER DIRECTOR 1.00 X 0 0 0 MICHAEL G MATHIS VICE CHAIR 1.00 X X 0 0 0 VALERIE COPELAND RUTLEDGE EDD SECRETARY 1.00 X X 0 0 0 RICHARD MCKENNEY DIRECTOR 1.00 X 0 0 0 ROBERT H SISKIN DIRECTOR 1.00 X 0 0 0 CAROL W SIM PRESIDENT AND CEO 50.00 X X 586930 0 142628 MONIQUE P BERKE DIRECTOR 1.00 X 0 0 0 CHARLES L ARANT DIRECTOR 1.00 X 0 0 0 JONES KROGH CPA CFP TREASURER 1.00 X X 0 0 0 JAMES J O'CONNELL III MD FABF DIRECTOR 1.00 X 0 0 0 JENNIFER L WEAVER DIRECTOR 1.00 X 0 0 0 JEFF LETT DIRECTOR 1.00 X 0 0 0 ELIZABETH BETSY MCCRIGHT DIRECTOR 1.00 X 0 0 0 VIMAL RAMJEE MD FACC DIRECTOR 1.00 X 0 0 0 MARCUS K SHAW DIRECTOR 1.00 X 0 0 0 WILLIAM F WILDER JR DIRECTOR 1.00 X 0 0 0 TANGELA W JOHNSON DIRECTOR 1.00 X 0 0 0 MATTHEW GIBSON PRESIDENT AND CEO 50.00 X X 0 0 0 CAROL E ARNHART VP FINANCE/CFO 50.00 X 234925 0 25408 TOD CAIN VP ADMINISTRATION 50.00 X 175932 0 37035 MICHAEL PILCHER INFO SYS DIRECTOR 50.00 X 162735 0 31724 TRACY REED VP PATIENT CARE 50.00 X 186245 0 40721 CURTIS POWELL VP QUALITY 50.00 X 162057 0 21339 TERESA DINGER ADMIN DIR MKTG 50.00 X 158718 0 12282 JOHN C YOUNG PSYCHOLOGIST 40.00 X 161551 0 11777 HOLLY TROTTER PHARMACY DIRECTOR 40.00 X 143323 0 12160 HERMAN GRIER PHARMACIST 40.00 X 125935 0 40526 2098351 0 375600 11 0 1 0 GENTECH CONTRUCTION 820 BROAD ST SUITE 400 CHATTANOOGA TN 37402 CONSTRUCTION SERVICES 5582663 SODEXHO MARRIOTT SERVICES PO BOX 360170 PITTSBURG PA 152516170 FOOD & FOOD SERVICE 2071743 ERLANGER MEDICAL CENTER 975 E THIRD STREET CHATTANOOGA TN 37403 MEDICAL SERVICES 897106 CHATTANOOGA SPINE & REHAB 1 SISKIN PLAZA SUITE 101 CHATTANOOGA TN 37403 MEDICAL SERVICES 364414 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 60673 INFORMATION SYSTEMS 236749 11 127500 687170 53430 868100 NET PATIENT REVENUE 621990 46686399 46686399 46686399 479342 42121 437221 552899 0 552899 552899 552899 3259460 6170 3852008 0 -592548 6170 -586378 -586378 232662 127500 108902 123760 123760 CAFETERIA 621990 192971 192971 SUPPORT SERVICE CONTRACTS 621990 176093 176093 MISCELLANEOUS REVENUE 621990 38273 38273 20601 20601 427938 48552060 47114337 42121 527502 43530 43530 1995444 1995444 23967075 19594137 4325194 47744 471414 356436 114978 3218722 2433673 784694 355 1829661 1380440 445708 3513 290894 166991 123903 83150 47733 35417 3391866 1947138 1444366 362 11915 6840 4555 520 2857895 1640606 1215175 2114 36696 21066 15597 33 112176 64396 47780 1147085 867310 279775 2492161 1884321 607840 600658 454157 146501 UBIT TAX 12738 7312 5426 MEDICAL SUPPLIES & DRUG 2167185 2167185 BAD DEBTS 759267 759267 OTHER SUPPLIES 576386 384825 189669 1892 871892 481978 389679 235 46937810 34709341 12171701 56768 1200 1300 13557070 15468115 5692141 4135744 222598 429468 456594 575985 227227 332963 75997943 41024906 33997436 34973037 19237442 21152957 47661471 49848309 1051399 16272 122104578 126934150 3944729 4764750 33929438 32503674 1614590 3305569 39488757 40573993 X 82350923 86177509 264898 182648 82615821 86360157 122104578 126934150 X 1614250 2130086 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9500 9500 0 PART II-B, LINE 1: PORTION OF HOSPITAL ASSOCIATION MEMBERSHIP DUES THAT ARE USED FOR LOBBYING. 18301418 585733 18887151 17758123 543295 18301418 16011032 1747091 17758123 13949772 2061260 16011032 14720118 -770346 13949772 1 0 260000 260000 50543685 19415295 31128390 22352730 19629024 2723706 2841528 1980587 860941 34973037 GT EMERGING MARKETS (QP) LP 2271867 F GT INSTITUTIONAL FIXED INCOME 3510523 F GT INTERNATIONAL EQUITY QP FUND LP 7866872 F GT OFFSHORE FUND LTD CLASS A 9637787 F GT OFFSHORE FUND LTD CLASS B 10627168 F GT REAL ASSETS II LP 1314026 F GT SPECIAL OPPORTUNITIES III LP 1616112 F GT US EQUITY FUND LP 13003954 F 49848309 SWAP AGREEMENT - LIABILITY 1916818 RESIDENT TRUST FUND 15604 REFUNDABLE ADVANCE 1373147 3305569 X 50682146 2130086 2130086 48552060 0 48552060 46937810 0 46937810 0 46937810 PART V, LINE 4: TO PROVIDE RESOURCES FOR VARIOUS ACTIVITIES CONSISTENT WITH THE MISSION OF THE HOSPITAL. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740-10 "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES." ASC 740-10 PROVIDES GUIDANCE ON DERECOGNITION OF TAX BENEFITS, CLASSIFICATION ON THE BALANCE SHEET, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2020 AND 2019. AS OF JUNE 30, 2020 AND 2019, THE HOSPITAL DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE HOSPITAL'S FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, FOR THE YEARS 2017 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAIN ON INTEREST RATE SWAP AGREEMENT -312,164. UNREALIZED GAIN ON OTHER THAN TRADING SECURITIES 2,442,250. GOLF TOURNAMENT 136620 50000 86620 36162 15107 5672 3282 POSSIBILITIES LUNCH 223542 77500 146042 1359 19440 25111 2769 360162 127500 232662 36162 16466 25112 25111 6051 108902 123760 1 1 1 X 1 X 0 1 0 0 352042 352042 0.00760 2127477 1586547 540930 0.01170 2479519 1586547 892972 0.01930 2304318 951125 1353193 0.02930 28350 28350 0.00060 2332668 951125 1381543 0.02990 4812187 2537672 2274515 0.04920 1 1001719 23518900 16401263 7117637 X 0 1 1 SISKIN HOSPITAL FOR PHYSICAL REHABILITATION 1 SISKIN PLAZA CHATTANOOGA TN 37403 WWW.SISKINREHAB.ORG #67 X INPATIENT REHABILITATION SISKIN HOSPITAL FOR PHYSICAL REHABILITAT 1 0 0 1 X X X X X X X X X 17 1 0 0 1 X WWW.SISKINREHAB.ORG 1 17 1 WWW.SISKINREHAB.ORG 0 1 X 200.000000000000 400.000000000000 X X X 0 1 X X X 1 X SISKINREHAB.ORG X SISKINREHAB.ORG X SISKINREHAB.ORG X X X X 0 1 X X 0 X X 0 0 SISKIN HOSPITAL FOR PHYSICAL REHABILITATION PART V, SECTION B, LINE 5: SISKIN HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ORDER TO DETERMINE THE NEEDS OF OUR COMMUNITY. DATA WAS COLLECTED AND ANALYZED FROM LOCAL, REGIONAL, STATE AGENCIES IN ORDER TO ACCURATELY AND ADEQUATELY IDENTIFY THE NEEDS OF OUR COMMUNITY THROUGH SERVICES PROVIDED BY SISKIN HOSPITAL. THE ASSESSMENT INCLUDED THE FOLLOWING: -ORGANIZATIONS THAT ARE AFFILIATED WITH SISKIN HOSPITAL FOR CONSUMER REFERRALS AND SEEK ASSISTANCE FOLLOWING RETURN TO THE COMMUNITY THROUGH A VOCATIONAL SERVICES PROGRAM. -INDIVIDUALS WHO RECEIVED SERVICES AT SISKIN HOSPITAL IN THE PAST TWO YEARS AND HAD EMAIL ADDRESSES AVAILABLE FOR ASSESSMENT DISSEMINATION. -GROUPS WHO REGULARLY INTERACT WITH THE HOSPITAL INCLUDING CASE MANAGERS, PHYSICIANS, THERAPISTS, AND SUPPORT GROUPS. -PATIENT SATISFACTION SURVEYS. SISKIN HOSPITAL FOR PHYSICAL REHABILITATION PART V, SECTION B, LINE 11: THE FOLLOWING AREAS OF CONSUMER AND COMMUNITY NEED WERE IDENTIFIED IN THE MOST RECENT CHNA REPORT: -TRANSPORTATION ASSISTANCE TO HEALTH SERVICES WE WILL ASSESS THIS OPPORTUNITY IN OUR NEXT STRATEGIC PLAN. -ACCESS TO REHABILITATION SERVICES THE EAST BRAINERD OUTPATIENT CLINIC WAS RELOCATED TO A LARGER, MORE CONVENIENT LOCATION TO ACCOMMODATE MORE PATIENTS. THE "DIRECT ACCESS" PROGRAM WAS IMPLEMENTED FOR SELF-REFERRAL FOR OUTPATIENT PHYSICAL THERAPY SERVICES. -QUALITY OF HEALTHCARE AND CAREGIVING PATIENT DISCHARGE SURVEYS ARE UTILIZED WITH THE GOAL OF CONTINUOUS IMPROVEMENT IN CUSTOMER SATISFACTION. SIGNIFICANT GAINS HAVE ALREADY BEEN INDICATED IN NEARLY EVERY SERVICE AREA. -EMPLOYMENT OPPORTUNITIES FOR INDIVIDUALS WITH DISABILITIES OUR VOCATIONAL SERVICES PROGRAM EVALUATES, INSTRUCTS, AND ASSISTS THE DISABLED WITH EMPLOYMENT SKILLS AND COMMUNITY RE-ENTRY. -KNOWLEDGE OF RESOURCES AVAILABLE CONDITION-SPECIFIC SUPPORT GROUPS MEET MONTHLY AT SISKIN HOSPITAL TO INFORM, EDUCATE AND SUPPORT. -SCHOLARSHIP BEDS SISKIN HOSPITAL SERVED 30 PATIENTS WITH NO INSURANCE AND 150 PATIENTS WITH INSUFFICIENT INSURANCE IN FY 2017. THE NEED CONTINUES TO BE GREAT BUT WE WILL CONTINUE TO STRETCH AVAILABLE RESOURCES WITHIN EXISTING FINANCIAL CONSTRAINTS. -INSURANCE LIMITATIONS SISKIN HOSPITAL WILL CONTINUE TO IDENTIFY AND SECURE CONTRACTS WITH INSURANCE PROVIDERS. THE FOLLOWING PROGRAMS BENEFIT COMMUNITIES SERVED: -COMMUNITY CARE PROGRAM SISKIN HOSPITAL PROVIDES CHARITY CARE FOR PHYSICAL REHABILITATION TO THOSE WHO HAVE SUSTAINED A DISABILITY THROUGH ACCIDENT, ILLNESS OR INJURY IN THE COMMUNITY IT SERVES. -CHARITABLE ASSISTANCE FOR ASSISTIVE DEVICES SISKIN HOSPITAL WORKS WITH COMMUNITY AGENCIES TO PROVIDE PATIENTS WITH THE EQUIPMENT AND EDUCATION THEY NEED TO PREVENT THEM FROM EXPERIENCING BARRIERS AT HOME, IN THE WORKPLACE OR THE COMMUNITY AT LARGE. -PROFESSIONAL TRAINING, EDUCATION, CLINICAL RESEARCH ACTIVITIES SISKIN HOSPITAL BELIEVES IN THE IMPORTANCE OF CONTINUING EDUCATION AND PROFESSIONAL TRAINING FOR OUR STAFF TO BETTER SERVE THOSE WITH DISABILITIES IN OUR COMMUNITY. STAFF PARTICIPATES IN ONGOING TRAINING OPPORTUNITIES TO OBTAIN SPECIAL CERTIFICATIONS IN A VARIETY OF TREATMENT AREAS INCLUDING NURSING, BRAIN INJURY, STROKE, PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, AND NURSING. -SISKIN HEALTH AND FITNESS CENTER THE HEALTH AND FITNESS CENTER IS A PLACE WHERE THE ABLE-BODIED AND THE DISABLED CAN WORK OUT SIDE BY SIDE, FOCUSING ON PERSONAL STRENGTHENING AND FITNESS GOALS. AS PART OF THE CONTINUUM OF CARE, SISKIN HOSPITAL OFFERS THE NEUROWELLNESS PROGRAM THAT TEACHES PATIENTS THE ESSENTIALS OF EXERCISE AND CONTINUES THEIR REHABILITATION PROGRESS AFTER BEING DISCHARGED FROM INPATIENT AND OUTPATIENT CARE. -ADVOCACY -VOCATIONAL ASSISTANCE - SISKIN HOSPITAL OFFERS EXTENSIVE EVALUATION, EDUCATION, SUPPORT AND TRAINING FOR INDIVIDUALS WITH BRAIN INJURIES. WORKING WITH CLIENTS AND POTENTIAL EMPLOYERS, THE STAFF PREPARES BOTH FOR RE-ENTRY INTO THE WORKFORCE. -OLDER AND DISABLED DRIVER SAFETY EVALUATION - THIS PROGRAM INCLUDES ON AND OFF-ROAD DRIVING EVALUATIONS FOR PATIENTS, SCREENINGS AND TREATMENT FOR LOW VISION, COGNITIVE EVALUATIONS, EDUCATION AND SUPPORT. THE PROGRAM HAS BEEN PRESENTED AT SEVERAL ASSISTED LIVING FACILITIES AS WELL. -TENNESSEE YELLOW DOT PROGRAM - THIS PROGRAM IS DESIGNED TO PROVIDE FIRST RESPONDERS WITH AN INDIVIDUAL'S MEDICAL INFORMATION IN THE EVENT OF AN EMERGENCY ON TENNESSEE'S ROADWAYS. SISKIN HOSPITAL IS AN ENROLLMENT SITE FOR THE PROGRAM. -ADVANCING CONTINUING EDUCATION - A NUMBER OF OUR NURSING STAFF HAS COMPLETED THE CERTIFIED REHABILITATION REGISTERED NURSE (CRRN) PROGRAM TO SECURE ADDITIONAL TRAINING FOR REHABILITATION CARE. STAFF IS ENCOURAGED TO OBTAIN SPECIALTY CERTIFICATIONS IN BRAIN INJURY, STROKE, LYMPHEDEMA AND OTHER TREATMENTS. -COMMUNITY SUPPORT GROUPS - THE HOSPITAL REGULARLY HOSTS OR SPONSORS SUPPORT GROUPS DESIGNED TO ADDRESS THE SOCIAL, EMOTIONAL, MEDICAL AND LEGAL ISSUES FACING COMMUNITY MEMBERS AND THEIR FAMILIES. SOME OF THE GROUPS OFFERED AT SISKIN HOSPITAL INCLUDE: ALS, AMPUTEE, BRAIN INJURY, EPILEPSY, LOW VISION, PARKINSON'S, SPINAL CORD AND STROKE. -FOOD AND CLOTHING DRIVES - SISKIN HOSPITAL MAINTAINS A PATIENT CARE FUND FOR DONATIONS THAT ARE USED FOR CLOTHING AND ADAPTIVE EQUIPMENT FOR PATIENTS WHO COULD NOT OTHERWISE AFFORD THEM. -MEDICAL EQUIPMENT DONATIONS - SISKIN HOSPITAL PARTNERS WITH GOODWILL OF CHATTANOOGA BY DONATING SURPLUS MEDICAL EQUIPMENT FOR ITS HELPS PROGRAM. DONATED ITEMS INCLUDE MOTORIZED WHEELCHAIRS, WALKERS AND TABLES. -COMMUNITY EDUCATION PROGRAMS - SISKIN HOSPITAL BELIEVES IN THE IMPORTANCE OF EDUCATING OUR PATIENTS AND OURSELVES. IN ADDITION TO OFFERING SEMINARS ON BRAIN INJURY AND STROKE, WE ALSO PROVIDE OFFICE SPACE FOR THE CHATTANOOGA BRAIN INJURY ASSOCIATION (CABIA) AND THE EPILEPSY FOUNDATION. WE ALSO PROVIDE EDUCATIONAL NOTEBOOKS TO PATIENTS IN THE STROKE, BRAIN INJURY AND AMPUTEE PROGRAMS. MANY STAFF ARE GUEST LECTURERS AT THE UNIVERSITY OF TENNESSEE AT CHATTANOOGA. -UNIQUE THERAPY PROGRAMS - REGIONALLY UNIQUE THERAPY PROGRAMS ADDRESS IDENTIFIED NEEDS, AND SPECIALTY PROGRAMS HAVE BEEN DEVELOPED TO INCLUDE LOW VISION, BALANCE AND DIZZINESS TREATMENT, LYMPHEDEMA TREATMENT, NEUROPSYCHOLOGICAL EVALUATIONS AND A VARIETY OF HEALTH AND FITNESS-ORIENTED PROGRAMS.COVID-19 IMPACT - MANY PROGRAMS WERE IMPACTED BY THE COVID-19 PANDEMIC WHICH BEGAN IN THE 4TH QUARTER OF THE TAX YEAR. SOME PROGRAMS, SUCH AS VOCATIONAL SERVICES, FITNESS CENTER, AND SUPPORT GROUPS HAD TO BE SUSPENDED. OTHER PROGRAMS ALONG WITH SOME OUTPATIENT SERVICES WERE CONVERTED TO USE ELECTRONIC MEANS. THE ORGANIZATION INTENDS TO CONTINUE TO MEET IDENTIFIED COMMUNITY NEEDS TO THE GREATEST EXTENT POSSIBLE DURING AND FOLLOWING THE PANDEMIC. 3 1 - ST BARNABAS AT SISKIN HOSPITAL 1 SISKIN PLAZA CHATTANOOGA TN 37403 SKILLED NURSING FACILITY 2 - SISKIN HOSPITAL THERAPY SERVICES 1309 PANORAMA DRIVE SUITE 103 CHATTANOOGA TN 37421 OUTPATIENT THERAPY CLINIC 3 - SISKIN HOSPITAL THERAPY SERVICES 3820 KEITH STREET CLEVELAND TN 37312 OUTPATIENT THERAPY CLINIC PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 759,267. PART III, LINE 4: TO DETERMINE THE AMOUNTS REPORTED IN PART III, LINE 2, SISKIN HOSPITAL REVIEWS INDIVIDUAL PATIENT ACCOUNTS ON AN ONGOING BASIS TO DETERMINE BAD DEBTS. BAD DEBT EXPENSE IS REPORTED IN THE FINANCIAL STATEMENTS AT 100% OF PATIENT CHARGES, BUT IS ADJUSTED TO COST USING COST TO CHARGE RATIO TO DETERMINE THE AMOUNT REPORTED ON PART III, LINE 2. BAD DEBT EXPENSE HAS NOT BEEN INCLUDED AS A COMMUNITY BENEFIT. NOTE FROM SISKIN HOSPITAL'S AUDITED FINANCIAL STATEMENTS, IN PERTINENT PART: NOTE (1)- DESCRIPTION OF ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES . . . PATIENT RECEIVABLES - FOR PATIENT RECEIVABLES, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON MANAGEMENT'S ASSESSMENT OF THE COLLECTABILITY OF SPECIFIC PATIENT'S ACCOUNTS AND THE AGING OF THE ACCOUNTS RECEIVABLE. IF THERE IS A DETERIORATION OF A PATIENT'S CREDITWORTHINESS OR ACTUAL DEFAULTS ARE HIGHER THAN HISTORICAL EXPERIENCE, MANAGEMENT'S ESTIMATES OF RECOVERABILITY OF AMOUNTS DUE TO THE HOSPITAL COULD BE ADVERSELY AFFECTED. . . ." PART VI, LINE 2: HEALTHCARE NEEDS ARE ASSESSED BY SISKIN HOSPITAL FOR PHYSICAL REHABILITATION THROUGH A VARIETY OF MECHANISMS, INCLUDING SURVEYS OF THOSE SERVED BY OUR PROGRAMS, TELEPHONE CALLS WITH SERVICE USERS, FEEDBACK FROM VARIOUS SUPPORT GROUPS AND THE INPUT GATHERED FROM ANNUAL ACCESSIBILITY PLANNING. THE HOSPITAL ALSO CONSIDERS COMMUNITY NEEDS THROUGH ITS STRATEGIC PLANNING PROCESS, WHERE INPUT IS SOUGHT FROM A VARIETY OF STAKEHOLDERS, INCLUDING COMMUNITY LEADERS, BOARD MEMBERS, OTHER PROVIDERS, EMPLOYEES AND PATIENTS. PART VI, LINE 3: INFORMATION TO INFORM AND EDUCATE PATIENTS REGARDING ASSISTANCE UNDER FEDERAL, STATE OR LOCAL PROGRAMS AND SISKIN HOSPITAL'S POLICIES IS AVAILABLE UPON ADMISSION AND IS POSTED IN PATIENT ROOMS. HOSPITAL BUSINESS OFFICE REPRESENTATIVES ARE AVAILABLE BEFORE, DURING AND FOLLOWING PATIENT STAYS TO DISCUSS PAYMENT ARRANGEMENTS,FINANCIAL ASSISTANCE, AND QUESTIONS ABOUT BILLING. FOR INPATIENT AND SUBACUTE REFERRALS, THE HOSPITAL'S NURSE LIAISONS ARE THE FIRST POINT OF CONTACT FOR INFORMATION DISSEMINATION TO PROSPECTIVE PATIENTS REGARDING AVAILABILITY OF ASSISTANCE, ELIGIBILITY CRITERIA AND APPLICATION INFORMATION. PART VI, LINE 4: SISKIN HOSPITAL FOR PHYSICAL REHABILITATION HAS A SERVICE AREA IN THE TRI-STATE AREA OF TENNESSEE, GEORGIA AND ALABAMA. THIS INCLUDES URBAN AND RURAL AREAS OF THE CUMBERLAND PLATEAU. SISKIN HOSPITAL OPERATES SEVERAL OUTPATIENT THERAPY CLINICS. THE POPULATIONS SERVED ENCOMPASS ALL ECONOMIC LEVELS. PART VI, LINE 5: SISKIN HOSPITAL IS AN INDEPENDENT, FREE-STANDING REHABILITATION HOSPITAL WHICH IS GOVERNED BY A COMMUNITY BOARD. SISKIN HOSPITAL OFFERS A CONTINUUM OF REHABILITATION SERVICES FROM ACUTE INPATIENT REHABILITATION TO SUBACUTE REHABILITATION AND OUTPATIENT SERVICES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND PSYCHOLOGY. IN ADDITION, SISKIN HOSPITAL OFFERS MANY UNFUNDED OR UNDER-FUNDED SERVICES, FOR WHICH IT IS THE SOLE COMMUNITY PROVIDER. SOME OF THESE INCLUDE COMMUNITY RE-ENTRY, VOCATIONAL EVALUATION AND SUPPORTED EMPLOYMENT, DRIVER EVALUATION AND TRAINING, AND FITNESS ACTIVITIES. SISKIN HOSPITAL SERVES AS A TRAINING SITE FOR SEVERAL NURSING PROGRAMS IN THE REGION AS WELL AS A STUDENT PRACTICE SITE FOR PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH/LANGUAGE PATHOLOGY STUDENTS FROM ACROSS THE NATION. PROGRAMS THAT BENEFIT COMMUNITIES SERVED BY SISKIN HOSPITAL:SISKIN HOSPITAL'S COMMUNITY CARE PROGRAM -- SISKIN HOSPITAL PROVIDES CHARITY CARE FOR PHYSICAL REHABILITATION TO THOSE WHO HAVE SUSTAINED A DISABILITY THROUGH ACCIDENT, ILLNESS OR INJURY IN THE COMMUNITY IT SERVES. CHARITY CARE IS PROVIDED FOR THOSE PATIENTS WITHOUT INSURANCE OR WITHOUT THE MEANS TO COVER THE COST OF THEIR TREATMENT. PROFESSIONAL TRAINING, EDUCATION, CLINICAL RESEARCH ACTIVITIES -- STAFF PARTICIPATE IN ONGOING TRAINING OPPORTUNITIES TO OBTAIN SPECIAL CERTIFICATIONS IN A VARIETY OF TREATMENT AREAS INCLUDING NURSING, BRAIN INJURY, STROKE, PHYSICAL AND OCCUPATIONAL THERAPY, AND SPEECH THERAPY. AS OF JUNE 2020, 68% OF ELIGIBLE NURSING STAFF WERE CRRN (CERTIFIED REHABILITATION REGISTERED NURSE) CERTIFIED. ADDITIONAL CERTIFICATIONS HAVE BEEN OBTAINED IN COMT (CERTIFIED ORTHOPEDIC MANIPULATIVE THERAPIST), LYMPHEDEMA, STROKE, ORTHOPEDIC, COMPLETE MANUAL DECONGESTIVE THERAPY, GERIATRIC, VESTIBULAR AND INTEGRATIVE THERAPY. RESEARCH ACTIVITIES HAVE INCLUDED STUDIES FOR PATIENTS WITH SWALLOWING ISSUES, FALL STATISTICS AND PREVENTION, CONCUSSION ASSESSMENT AND PSYCHOLOGY/BEHAVIORAL HEALTH ASSESSMENT AND TREATMENT.THE SISKIN HEALTH & FITNESS CENTER -- AS PART OF THE CONTINUUM OF CARE, SISKIN IS PROUD TO OFFER THE NEUROWELLNESS PROGRAM AT THE HEALTH & FITNESS CENTER. IN NINE WEEKS, PATIENTS LEARN THE ESSENTIALS OF EXERCISE AND CONTINUE THEIR REHABILITATION PROGRESS AFTER BEING DISCHARGED FROM INPATIENT AND OUTPATIENT CARE. THE HEALTH & FITNESS CENTER IS A PLACE WHERE THE ABLE-BODIED AND THE DISABLED CAN WORK OUT SIDE BY SIDE, FOCUSING ON PERSONAL STRENGTHENING AND FITNESS GOALS. IT IS CONSIDERED TO BE A COMFORTABLE, SAFE PLACE FOR PEOPLE OF ALL ABILITIES, INCLUDING THOSE LESS FIT, SENIORS AND PERSONS WITH VARYING DEGREES OF DISABILITY. THE MAJORITY OF HEALTH & FITNESS CENTER MEMBERS ARE EITHER OVER AGE 65, FORMER PATIENTS OR DISABLED INDIVIDUALS. TO MAKE THE CENTER WIDELY AVAILABLE TO THIS POPULATION, SISKIN HOSPITAL SUBSIDIZES THE OPERATION OF THIS FACILITY, ALLOWING THE MEMBERSHIP RATES TO REMAIN AFFORDABLE. A MATTER OF BALANCE: THIS FALLS PREVENTION CLASS IS A JOINT VENTURE BETWEEN THE HAMILTON COUNTY HEALTH DEPARTMENT AND SISKIN HOSPITAL. THE FREE TWO-HOUR CLASS, HELD IN THE HEALTH & FITNESS CENTER, TEACHES PRACTICAL STRATEGIES TO MANAGE FALLS AND IS PARTICULARLY HELPFUL TO OLDER ADULTS WHO HAVE RESTRICTED THEIR ACTIVITIES BECAUSE OF, OR IN FEAR OF, FALLING. VOCATIONAL ASSISTANCE - THROUGH THE VOCATIONAL SERVICES DEPARTMENT AND COMMUNITY RE-ENTRY SERVICES, SISKIN HOSPITAL OFFERS EXTENSIVE EVALUATION, EDUCATION, SUPPORT AND TRAINING FOR INDIVIDUALS WITH BRAIN INJURIES AS A RESULT OF ACCIDENT, ILLNESS OR INJURY. FROM THE INITIAL EVALUATION WHERE AN INDIVIDUAL'S STRENGTHS, WEAKNESSES AND SKILL-SET ARE DETERMINED, SISKIN HOSPITAL STAFF WORK TO TRAIN AND PREPARE CLIENTS TO RETURN TO EMPLOYMENT AND A MORE ACTIVE LIFESTYLE BASED ON THE INDIVIDUAL'S INTERESTS AND NEEDS. ADDITIONALLY, STAFF WORKS CLOSELY WITH POTENTIAL EMPLOYERS TO EDUCATE AND PREPARE THEM TO WORK WITH PEOPLE WHO HAVE A DISABILITY. ONCE CLIENTS OBTAIN EMPLOYMENT, STAFF WORKS TO TRANSITION THEM INTO THEIR NEW JOB BY ENSURING THEIR UNDERSTANDING AND ABILITY TO PERFORM TASKS AS THEY ARE ASSIGNED. OLDER AND DISABLED DRIVER SAFETY EVALUATION - SISKIN HOSPITAL HAS SUPPORTED THE COMMUNITY WITH ITS DRIVER EVALUATION PROGRAM FOR A NUMBER OF YEARS. THIS PROGRAM INCLUDES ON-AND OFF-ROAD DRIVING EVALUATIONS FOR PATIENTS, SCREENINGS AND TREATMENT FOR LOW VISION, COGNITIVE EVALUATIONS, EDUCATION AND SUPPORT. IN ADDITION, SISKIN HOSPITAL STAFF HAVE PRESENTED THE PROGRAM AT LOCAL ASSISTED LIVING FACILITIES TO PROMOTE SAVE DRIVING FOR THE ELDERLY AND DISABLED. SISKIN HOSPITAL WORKS CLOSELY WITH THE TENNESSEE DEPARTMENT OF TRANSPORTATION, HAMAN'S DRIVING SCHOOL, AND LOCAL OPHTHALMOLOGISTS AND PSYCHOLOGISTS TO ENSURE THAT INDIVIDUALS WHO PROGRESS THROUGH THE DRIVING PROGRAM AT SISKIN HOSPITAL RECEIVE THE EDUCATION, TRAINING AND EQUIPMENT NEEDED TO DRIVE SAFELY.ADVANCING CONTINUING EDUCATION - SISKIN HOSPITAL RECOGNIZES THE NEED FOR CONTINUING EDUCATION AND SUPPORTS THOSE WHO DESIRE TO FURTHER THEIR KNOWLEDGE AND TRAINING IN PHYSICAL MEDICINE AND REHABILITATION. A NUMBER OF OUR NURSING STAFF HAS COMPLETED THE CERTIFIED REHABILITATION REGISTERED NURSE (CRRN) PROGRAM TO SECURE ADDITIONAL TRAINING FOR REHABILITATION CARE. WE ALSO ENCOURAGE AND SUPPORT STAFF TO OBTAIN SPECIALTY CERTIFICATIONS IN BRAIN INJURY, STROKE, LYMPHEDEMA AND OTHER TREATMENTS. SOME TUITION COSTS AND EXPENSES ARE REIMBURSED THROUGH SISKIN HOSPITAL. NURSING SCHOLARSHIPS HAVE BEEN PROVIDED FOR A NUMBER OF YEARS AND WERE INITIALLY FUNDED BY AN EXTERNAL GRANT PROVIDED BY THE WRIGHT-BENTLEY FOUNDATION. SISKIN HOSPITAL ALSO RECEIVED FULL FUNDING FROM THE TENNESSEE HOSPITAL ASSOCIATION'S PROMISE OF NURSING GRANT, WHICH PROVIDED THE RESOURCES TO SIX NURSING STUDENTS FOR A 10-WEEK INTENSIVE SUMMER INTERNSHIP. ADDITIONALLY, A WORKING PARTNERSHIP WITH THE UNIVERSITY OF TENNESSEE AT CHATTANOOGA HAS DEVELOPED INTO A DOCTORATE PROGRAM FOR OCCUPATIONAL THERAPY.COMMUNITY SUPPORT GROUPS - SISKIN HOSPITAL HOSTS OR SPONSORS SUPPORT GROUPS DESIGNED TO ADDRESS THE SOCIAL, EMOTIONAL, MEDICAL AND LEGAL ISSUES FACING COMMUNITY MEMBERS AND THEIR FAMILIES. SOME OF THE GROUPS OFFERED AT SISKIN HOSPITAL INCLUDE: ALS, AMPUTEE, BRAIN INJURY, EPILEPSY, LOW VISION, PARKINSON'S, SPINAL CORD AND STROKE. THESE PROGRAMS ARE FREE AND OPEN TO THE GENERAL COMMUNITY. COMMUNITY EDUCATION PROGRAMS - SISKIN HOSPITAL OFFERS FREE WEEKLY SEMINARS ON BRAIN INJURY AND STROKE TO PATIENTS AND FAMILY MEMBERS. THE HOSPITAL HOSTS CONTINUING EDUCATION COURSES AVAILABLE TO THE COMMUNITY, INCLUDING CERTIFIED AGING IN PLACE SPECIALIST, UNIVERSAL DESIGN COURSES AND OTHERS OF INTEREST TO HEALTHCARE STAFF. IN ADDITION, SEVERAL OF OUR OCCUPATIONAL AND PHYSICAL THERAPISTS ARE GUEST LECTURERS AND LAB ASSISTANTS AT THE UNIVERSITY OF TENNESSEE CHATTANOOGA. THE HOSPITAL SPONSORS FALL PREVENTION AWARENESS DAYS AND ANNUALLY HOSTS HIXSON HIGH SCHOOL'S HEALTH OCCUPATION STUDENTS. IT ALSO PARTICIPATES IN THE UTC SCHOOL OF NURSING'S FALL SUMMIT ALONG WITH THE HEALTH DEPARTMENT AND CABIA; THE LOW VISION EXPO; AND CONDUCTS A MATTER OF BALANCE, AN EVIDENCE-BASED PROGRAM AT THE FITNESS CENTER FOR SENIORS. HOSPITAL STAFF HAS PRESENTED THE DRIVE SAFE CHATTANOOGA PROGRAM AT THE AMERICAN MEDICAL REHABILITATION PROVIDERS ASSOCIATION, AND THE HOSPITAL HAS CO-SPONSORED STROKE CAMP, A WEEKEND RETREAT FOR STROKE VICTIMS AND THEIR FAMILIES. STAFF MAN BOOTHS AT AGING SEMINARS AND CAREER FAIRS, PRESENT AS GUEST SPEAKERS TO CABIA CONFERENCES, AND TEACH DISCIPLINE-SPECIFIC COURSES AT STATE ORGANIZATIONS. EACH YEAR SISKIN HOSPITAL'S INPATIENT THERAPY DEPARTMENTS TAKE ON A COHORT OF THERAPY STUDENTS AT VARIOUS LEVELS IN THEIR COURSE OF STUDY. ITS NURSING DEPARTMENT PROVIDES CLINICAL EXPERIENCES FOR LOCAL COLLEGE AND UNIVERSITY NURSING STUDENTS, AND PROVIDES GUEST LECTURERS ON REQUEST. SISKIN HOSPITAL HAS REPRESENTATION ON THE LOCAL BOARDS OF CABIA, STS, EPILEPSY FOUNDATION, AND CHAMBLISS CENTER.UNIQUE THERAPY PROGRAMS - REGIONALLY UNIQUE THERAPY PROGRAMS ADDRESS IDENTIFIED NEEDS, AND SPECIALTY PROGRAMS HAVE BEEN DEVELOPED TO INCLUDE LOW VISION, BALANCE AND DIZZINESS TREATMENT, LYMPHEDEMA TREATMENT, NEUROPSYCHOLOGICAL EVALUATIONS AND A VARIETY OF HEALTH AND FITNESS-ORIENTED PROGRAMS. SISKIN HOSPITAL FOR PHYSICAL REHABILITATION COMMUNITY HEALTH NEEDS ASSESSMENT 55 SISKIN HOSPITAL RECEIVED A $194,650 MULTI-YEAR GRANT FROM THE CHATTANOOGA OPHTHALMOLOGIC FOUNDATION TO INCREASE AND IMPROVE SERVICES FOR PERSONS WITH IMPAIRED VISION. 1 SCHOLARSHIP/TUITION REIMBURSEMENT 16 43530 PART I, LINE 2: APPLICATIONS ARE FILED TO DETERMINE QUALIFICATIONS. SCHOLARSHIPS ARE AWARDED ON A NONDISCRIMATORY BASIS BASED ON NEED AND QUALIFICATIONS. X X 0 0 0 0 0 0 0 0 0 CAROL W SIM PRESIDENT AND CEO 460650 0 126280 0 0 0 137440 0 5188 0 729558 0 126280 0 CAROL E ARNHART VP FINANCE/CFO 195281 0 28388 0 11256 0 9500 0 15908 0 260333 0 0 0 TOD CAIN VP ADMINISTRATION 151762 0 24170 0 0 0 28251 0 8784 0 212967 0 24170 0 MICHAEL PILCHER INFO SYS DIRECTOR 150735 0 12000 0 0 0 26536 0 5188 0 194459 0 0 0 TRACY REED VP PATIENT CARE 154948 0 19818 0 11479 0 6253 0 34468 0 226966 0 0 0 CURTIS POWELL VP QUALITY 131977 0 15197 0 14883 0 5691 0 15648 0 183396 0 0 0 TERESA DINGER ADMIN DIR MKTG 128552 0 30166 0 0 0 6574 0 5708 0 171000 0 0 0 JOHN C YOUNG PSYCHOLOGIST 92741 0 62600 0 6210 0 3383 0 8394 0 173328 0 0 0 HOLLY TROTTER PHARMACY DIRECTOR 134972 0 1721 0 6630 0 6972 0 5188 0 155483 0 0 0 HERMAN GRIER PHARMACIST 114805 0 1560 0 9570 0 5538 0 34988 0 166461 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN WILL BE REVIEWED BY THE AUDIT COMMITTEE AND DISTRIBUTED TO ALL DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL DISCLOSURE FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIAL: THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FUNCTIONS AS THE COMPENSATION COMMITTEE RESPONSIBLE FOR THE PERFORMANCE REVIEW OF THE CHIEF EXECUTIVE OFFICER AND ANY ADJUSTMENTS IN COMPENSATION FOR IMMEDIATE SUBORDINATES AT THE EXECUTIVE LEVEL. THE EXECUTIVE COMMITTEE UTILIZES DATA FROM SALARIES AND COMPENSATION PROGRAMS, AND SELECTED BENEFIT PROGRAMS. THESE ARE COMPILED BY THE US DEPARTMENT OF JUSTICE/FEDERAL TRADE COMMISSION GUIDELINES ON SALARY SURVEYS. THESE DATA ARE FROM NATIONALLY RECOGNIZED FREE-STANDING REHABILITATION HOSPITALS IN THE UNITED STATES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN NET UNREALIZED GAINS ON OTHER THAN TRADING SECURITIES 2,442,250. UNREALIZED LOSS ON INTEREST SWAP AGREEMENT -312,164.