MONROE MEDICAL FOUNDATION INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MONROE MEDICAL FOUNDATION INC (EIN 31-0949874)
- Tax period
- 2017-03-01 to 2018-02-28
- Filed
- 2019-01-14
- IRS object ID
- 201910159349300716
- Schema version
- 2017v2.0
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-01-14T23:05:25-07:00 | ReturnTs |
| Tax Period End | 2018-02-28 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310949874 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONROE MEDICAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONR | BusinessNameControlTxt |
| Phone | 2704879231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 529 CAPP HARLAN ROAD | AddressLine1Txt |
| City | TOMPKINSVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42167 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Rickie Brown | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Phone | 2704879231 | PhoneNum |
| Signature | 2019-01-14 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.31.62.120 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monroe County Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Jimmy Goodman | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2841 Akersville Rd | AddressLine1Txt |
| City | Fountain Run | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42133 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,140,643 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.mcmccares.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL - Our mission is to be a rural healthcare organization who values compassion, respect and confidentiality, and to provide quality, safe, primary and specialty services for the citizens of Monroe County and surrounding area through detection, prevention and treatment of illness. We achieve this by operating a 49 bed acute care hospital, ambulance service and county 911 service. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 289 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $564,930 | PYContributionsGrantsAmt |
| CY Contributions Grants | $582,669 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,593,448 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,394,049 | CYProgramServiceRevenueAmt |
| PY Investment Income | $133,898 | PYInvestmentIncomeAmt |
| CY Investment Income | $156,305 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,425 | PYOtherRevenueAmt |
| CY Other Revenue | $7,620 | CYOtherRevenueAmt |
| PY Total Revenue | $18,299,701 | PYTotalRevenueAmt |
| CY Total Revenue | $19,140,643 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $50,498 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $37,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,114,355 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,989,154 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,034,205 | PYOtherExpensesAmt |
| CY Other Expenses | $8,191,245 | CYOtherExpensesAmt |
| PY Total Expenses | $18,199,058 | PYTotalExpensesAmt |
| CY Total Expenses | $19,217,399 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $100,643 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$76,756 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,313,373 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,211,545 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,944,517 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,919,445 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,368,856 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,292,100 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ACUTE CARE HOSPITAL - The mission of the Monroe Medical Foundation, Inc. is to be a rural healthcare organization who values compassion, respect and confidentiality, and provides quality, safe, primary and specialty services for the citizens of Monroe County and surrounding area through detection, prevention and treatment of illness. We achieve this by operating a 49 bed acute care hospital, ambulance service and county 911 service. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,298,154 | ExpenseAmt |
| Grant | $9,000 | GrantAmt |
| Revenue | $18,410,169 | RevenueAmt |
| Desc | Inpatient Care - Monroe Medical Foundation, Inc. operates a 49 bed acute care hospital. The hospital admitted 1,304 patients treated 7,071 patients in the emergency room, treated 24,458 patients as outpatient referrals and made 2,038 ambulance runs in FYE 2-28-18. The patients admitted to the hospital as regular inpatients consisted of approximately 59% Medicare patients and 20% Medicaid patients. Approximately 1% of patients admitted did not have Medicare or Medicaid, and did not have any type of insurance. The hospital also began providing Swing Bed services in December 2014. We admitted 83 patients to the swing bed status during the fiscal year, and we had 711 swing bed patient days. (Grants included 7 high school graduates' scholarships, 1 physician receiving assistance with his medical school loans and 1 individual in Medical School). | Desc |
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $17,298,154 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 289 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monroe County Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2704879231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 529 CAPP HARLAN ROAD | AddressLine1Txt |
| City | TOMPKINSVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42167 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Judy Rowland | ||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Fowler Ross JR OD | ||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Jimmy Goodman | ||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Mike Starnes | ||||||||
| Board 1st Vice President | 1 | 0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Polly Baker | ||||||||
| Board President | 1 | 0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Kem Coe 2nd Vice President Sec | ||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Greg Crabtree DMD | ||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Kimberly Eakle MD | ||||||||
| Board Member/ Physician | 13 | 0 | Yes (X) | $93,250 | $0 | $0 | ||
| Timothy Hume MD | ||||||||
| Board Member/Physician | 13 | 0 | Yes (X) | $67,045 | $0 | $0 | ||
| Anthony Carter MD | ||||||||
| Physician | 40 | 0 | Yes (X) | $560,491 | $0 | $0 | ||
| Vicky McFall | ||||||||
| Exec Director/CEO | 40 | 0 | $0 | $0 | $0 | Yes (X) | ||
| Rickie Brown | ||||||||
| Chief Financial Officer | 40 | 0 | $0 | $0 | $0 | Yes (X) | ||
| Deborah Bentley | ||||||||
| Director of Pharmacy | 40 | 0 | $136,031 | $0 | $0 | Yes (X) | ||
| Andrea McAlpin | ||||||||
| Pharmacist | 40 | 0 | $123,359 | $0 | $0 | Yes (X) | ||
| William M Carter MD | ||||||||
| Physician | 40 | 0 | $180,000 | $0 | $0 | Yes (X) | ||
| Lisa K Davis | ||||||||
| Chief Clinical Officer | 40 | 0 | $100,615 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,260,791 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Quorum Health Resources LLC | ||||||
| 1573 Mallory Lane Suite 200 | Brentwood | TN | 37027 | Management Contract & Provides CEO and CFO | $712,692 | |
| Inspire Medical Inc | ||||||
| 2323 Lime Kiln Lane | Louisville | KY | 40222 | Emergency Room Physicians | $1,299,019 | |
| MedHost of Tennessee Inc | ||||||
| 2739 Momentum Place | Chicago | IL | 60689 | Computer Software Hardware and Maintenance | $345,154 | |
| Healthcare Therapy Services | ||||||
| 1411 W County Line Road | Greenwood | IN | 46142 | Therapy Services | $191,852 | Suite A |
| Siemens Medical Solutions Inc | ||||||
| 40 Liberty Boulevard | Malvern | PA | 19355 | Maintenance Service and Equipment Purchases | $1,527,000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $582,669 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $582,669 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Hospital Services, Net of Contractual Adjustments and Charity Discounts and Allowance for Bad Debts | 622000 | $18,304,616 | $18,304,616 | $0 | $0 |
| Meaningful Use Money | 622000 | $89,433 | $89,433 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,394,049 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $147,805 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $147,805 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $8,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $8,500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,500 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,500 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,620 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,620 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,620 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,140,643 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,410,169 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $147,805 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,000 | TotalAmt |
| Program Services | $37,000 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $679,710 | TotalAmt |
| Program Services | $679,710 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,713,414 | TotalAmt |
| Program Services | $8,128,017 | ProgramServicesAmt |
| Management And General | $585,397 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,470 | TotalAmt |
| Program Services | $117,565 | ProgramServicesAmt |
| Management And General | $7,905 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $819,456 | TotalAmt |
| Program Services | $767,830 | ProgramServicesAmt |
| Management And General | $51,626 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $651,104 | TotalAmt |
| Program Services | $610,084 | ProgramServicesAmt |
| Management And General | $41,020 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $711,369 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $711,369 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,968 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,968 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,965 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $32,965 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $505,002 | TotalAmt |
| Program Services | $402,924 | ProgramServicesAmt |
| Management And General | $102,078 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,058 | TotalAmt |
| Program Services | $9,058 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,265,560 | TotalAmt |
| Program Services | $2,200,076 | ProgramServicesAmt |
| Management And General | $65,484 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,223 | TotalAmt |
| Program Services | $282,777 | ProgramServicesAmt |
| Management And General | $39,446 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $433,487 | TotalAmt |
| Program Services | $331,184 | ProgramServicesAmt |
| Management And General | $102,303 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,019 | TotalAmt |
| Program Services | $23,929 | ProgramServicesAmt |
| Management And General | $4,090 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,287 | TotalAmt |
| Program Services | $7,589 | ProgramServicesAmt |
| Management And General | $698 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,592 | TotalAmt |
| Program Services | $21,592 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,484 | TotalAmt |
| Program Services | $1,029,539 | ProgramServicesAmt |
| Management And General | $23,945 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,048 | TotalAmt |
| Program Services | $114,455 | ProgramServicesAmt |
| Management And General | $7,593 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PHYSICIAN FEES | $1,632,574 | $1,632,574 | $0 | $0 |
| REPAIRS AND MAINTENANCE | $333,159 | $322,677 | $10,482 | $0 |
| KENTUCKY PROVIDER TAX | $319,453 | $319,453 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,997 | TotalAmt |
| Program Services | $260,121 | ProgramServicesAmt |
| Management And General | $130,876 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,217,399 | TotalAmt |
| Program Services | $17,298,154 | ProgramServicesAmt |
| Management And General | $1,919,245 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,452 | BOYAmt |
| EOY | $14,593 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,474,775 | BOYAmt |
| EOY | $1,662,992 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,866,302 | BOYAmt |
| EOY | $1,955,646 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,471 | BOYAmt |
| EOY | $372,510 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,638 | BOYAmt |
| EOY | $161,722 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,087,187 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,664,499 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,904,214 | BOYAmt |
| EOY | $10,422,688 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,558,521 | BOYAmt |
| EOY | $12,621,394 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,313,373 | BOYAmt |
| EOY | $27,211,545 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,234,606 | BOYAmt |
| EOY | $1,224,091 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $709,911 | BOYAmt |
| EOY | $695,354 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,944,517 | BOYAmt |
| EOY | $1,919,445 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,135,892 | BOYAmt |
| EOY | $25,126,847 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,964 | BOYAmt |
| EOY | $165,253 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,368,856 | BOYAmt |
| EOY | $25,292,100 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,313,373 | BOYAmt |
| EOY | $27,211,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$76,756 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $378,922 | OtherCostOrOtherBasisAmt |
| Book Value | $378,922 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $12,381,734 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,048,843 | DepreciationAmt |
| Book Value | $6,332,891 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $19,326,531 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,615,656 | DepreciationAmt |
| Book Value | $3,710,875 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,422,688 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| FUNDED DEPRECIATION | $11,733,199 |
| CASH RESTRICTED FOR ADULT DAYCARE | $16,879 |
| OTHER RECEIVABLES | $522,836 |
| OTHER ASSETS | $7,375 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $341,105 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $12,621,394 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE OBLIGATIONS | $199,613 |
| ESTIMATED THIRD-PARTY SETTLEMENTS | $495,741 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $695,354 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $19,140,643 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $0 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Recoveries Prior Year Grants | $0 | RecoveriesPriorYearGrantsAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,140,643 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $0 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,140,643 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,217,399 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $0 | DonatedServicesUseFcltsAmt |
| Prior Year Adjustments | $0 | PriorYearAdjustmentsAmt |
| Losses Reported | $0 | LossesReportedAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $19,217,399 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $0 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,217,399 | TotalExpensesPerForm990Amt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $448,807 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $448,807 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.023 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,913,287 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,729,373 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,183,914 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.062 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $4,362,094 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,729,373 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,632,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.085 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,301 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,301 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0015 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0005 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $38,301 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,301 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $4,400,395 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,729,373 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,671,022 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0870 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $377,952 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $75,590 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,463,935 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,940,579 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $523,356 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Quorum Health Resources LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Management Company | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monroe County Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 529 Capp Harlan Road | AddressLine1Txt |
| City | Tompkinsville | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42167 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | mcmccares.com | WebsiteAddressTxt |
| State License | 100338 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monroe County Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | mcmccares.com | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | mcmccares.com | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | mcmccares.com | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | mcmccares.com | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | mcmccares.com | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-Monroe County Medical Center | In conducting the CHNA, the hospital facility took into account input from persons who represent broad interests of the community served by the hospital facility. It included 26 local expert advisors from the county. They included representatives from the Board of Education, Health Department, Department of Social Services, Community Action of Southern Kentucky, Monroe County Extension Office, Housing Authority, Drug Court, Community Outreach, Religious Official, County Judge Executive, Mayor of Tompkinsville, Mayor of Gamaliel, Local Nursing Home, State Representative, Life Skills, Cancer Support Group, Dietician, Dentists, Project 12 Coordinator and Monroe County Extension Office. |
| Schedule H, Part V, Section B, Line 6b-Monroe County Medical Center | The hospital facility's CHNA was conducted with various organizations other than hospital facilities. It was conducted in conjunction with leaders and experts from the local county and Quorum Health Resources. It included 26 local expert advisors from the county. They included representatives from the Board of Education, the Health Department, Department of Social Services, Community Action of Southern Kentucky, Monroe County Extension Office, Housing Authority, Drug Court, Community Outreach, Religious Official, County Judge Executive, Mayor of Tompkinsville, Mayor of Gamaliel, Local Nursing Home, State Representative, Life Skills, Cancer Support Group, Dietician, Dentists, Project 12 Coordinator, Monroe County Extension Office and other individuals of the Community. |
| Schedule H, Part V, Section B, Line 11-Monroe County Medical Center | 1. Substance Abuse - The hospital provides a location for CARES organization with volunteer representative from the hospital. The hospital provides a meeting space for Narcotics Anonymous group. The hospital promotes prescription take-back events and drug drop boxes in the community. The hospital ER physicians only prescribe narcotics for acute injuries, but send chronic pain issues to PCOs. The hospital facilitated bringing in pain management clinic to help provide treatment and alternatives to prescription pain medicine. The pain management clinic left the community in December 2017. We are looking to replace them. The hospital sponsors Project 12, a local coalition to help educate on and address substance abuse in the community. The hospital provides CMEs to the medical staff on opioid addiction,. The hospital provided a sample contract to physician offices to use with patients to manage narcotics' prescriptions. The hospital did not implement other strategies due to resource constraints and a lack of expertise or competency to address this need. Also, our hospital employed physician is obtaining education to prescribe suboxone as an alternative to opiod addiction. Hospital administration has met with one company to provide intensive outpatient counseling. We are continuing to interview companies. 2. Heart Disease, Diabetes and Obesity - Hospital dietician provides free counseling to anyone in the community for diabetes, heart healthy habits, etc.. The Diabetic support group sponsored by the hospital meets monthly at the hospital. The hospital sponsors the annual diabetes health fair that provides free hemoglobin A1C screenings. The hospital participates weekly in the radio talk show, Monroe Mondays, to cover key health topics including diabetes, heart disease, and healthy living. Hospital purchased a new CT Scanner with the ability of performing Calcium Scoring procedures. We have performed 332 to date with 10.24% positive for early detection. Hospital administration and medical staff met with a company to provide dialysis locally. They determined the population did not meet the company's service demands. 3. Cancer - The hospital purchased a new 3D mammography machine and now offers 3D with 100% increase in mammograms. ACO Care Coordinator works with patients to help afford medications through Kentucky Prescription Assistance Program, and promotes wellness screenings including cholesterol, mammograms and colonoscopies. Hospital is a sponsor of Relay for Life. Hospital provides tobacco cessation education to every patient. Hospital provided education program for medical staff on Low Dose CT Screening by Kentucky Cancer Program. CT Scanner was purchased with low dose software and has performed 75 procedures with 21.33% positive for early detection. We also signed a contract with a local hospice company to provide local inpatient services to terminal patients. These are just a few of the things the hospital is doing for this need. |
| Schedule H, Part V, Section B, Line 24-Monroe County Medical Center | All patients are initially charged the same rates. If the patient meets the financial assistance policy provisions, the charges are discounted according to the provisions of the Financial Assistance Policy. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Monroe County Ambulance Service | ||||
| 429 Capp Harlan Road | Tompkinsville | KY | 42167 | Ambulance Service operated for the county. |
| Monroe County 911 Service | ||||
| 429 Capp Harlan Road | Tompkinsville | KY | 42167 | 911 Service operated for the county. |
| Monroe County Medical Center Medical Practice | ||||
| 604 N Main | Tompkinsville | KY | 42167 | Physician Office Practice |
| Monroe County Medical Center Medical Practice | ||||
| 606 N Main Street | Tompkinsville | KY | 42167 | Physician Office Practice |
| Monroe County Medical Center Adult Daycare | ||||
| 417 Capp Harlan Road | Tompkinsville | KY | 42167 | Adult Daycare Service |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 6a | The hospital facility's CHNA was conducted with various organizations other than hospital facilities. It was conducted in conjunction with leaders and experts from the local county and Quorum Health Resources. It included 26 local expert advisors from the county. they included representatives from the Board of Education, the Health Department, Department of Social Services, Community Action of Southern Kentucky, Monroe County Extension Office, Housing Authority, Drug Court, Community Outreach, Religious Official, County Judge Executive, Mayor of Tompkinsville, Mayor of Gamaliel, Local Nursing Home, State Representative, Life Skills, Cancer Support Group, Dietician, Dentists, Project 12 Coordinator, Monroe County Extension Office and other individuals of the Community. |
| Schedule H, Part I, Line 7 | Ratio of Patient Care Cost to Charges was used as the costing methodology. |
| Schedule H, Part I, Line 7g | There were no costs attributable to a physician clinic included as subsidized health services in line 7(g). |
| Schedule H, Part III, Section A, Line 4 | The notes in the financial statements that describe bad debt expense are located on pages 10 and page 11 of the Audit Report. The costing methodology used to determine the amounts reported on Part III, Section A, Line 2 is based on the ratio of Patient Care Cost to Charges applied to the gross amounts written off as bad debts. |
| Schedule H, Part III, Section B, Line 8 | There is no shortfall on Medicare. The costing methodology used is the Ratio of Patient Care Cost to Charges applied to the gross charges. |
| Schedule H, Part III, Section C, Line 9b | Upon registration, financial information is gathered when possible, to determine if they qualify for charity or financial assistance. If they are not able to provide the information at that time, they are given a financial information form to complete later. If they are admitted to the hospital, the patient financial counselor goes to the patient room and discusses the charity and financial assistance information with the patient. If we are unable to obtain the necessary information from the patient at that time, we send the information to a contracted company to obtain the necessary information, and assist them in obtaining the information and financial assistance they qualify for. |
| Schedule H, Part VI, Line 2 | The hospital also has suggestion boxes for patients, visitors and employees to obtain suggestions for new or better health services. In addition, the hospital obtains input from the physicians, visitors and employees at the annual Board/Medical Staff planning retreat. |
| Schedule H, Part VI, Line 3 | The Financial Assistance Policy Plain Language Summary is posted on the wall in the registration offices. There are also copies of the Financial Assistance Applications in the registration areas available for the patients. In addition, the Financial Policy Plain Language Summary is posted in the exam rooms in the emergency department and in various ancillary outpatient waiting areas. If the patients do not have Medicare, Medicaid or any other type of insurance, the patient information is provided to a contracted company to follow up with the patients to help them obtain medical cards and assists them in getting the necessary information to qualify for financial assistance. If the patient is admitted, the Patient Financial Counselor visits the patient in the patient room and discusses their financial options. The hospital's Financial Assistance Policy is also posted on the hospital's web site. |
| Schedule H, Part VI, Line 4 | The Monroe County Medical Center is located in Monroe County, Kentucky which is a rural area of Kentucky. The hospital primarily serves the citizens of Monroe County and parts of the joining counties. The population of Monroe County is approximately 10,700. Only approximately 14.8% of persons age 25 and above have a bachelor's degree or higher compared to 30.4% for the national average. The Median household income is approximately $35,665 compared to the national median household income of $59,039. Approximately 24.3% of the persons in Monroe County live below the poverty level compared to 12.3% for the national average. The unemployment rate for Monroe County is 4.3% compared to the national average of 4.1%. The primary industries in Monroe County are a concrete plant manufacturer, lumber and agriculture. |
| Schedule H, Part VI, Line 5 | The Monroe County Medical Center has an open medical staff to promote patient care for the citizens of our community. The Board of Directors of the Monroe Medical Foundation, Inc. is made up of nine individuals. All of them reside in Monroe County, and serve on the Board with no pay for providing those services. They serve because they are interested in the Community and want to give something back to the Community by helping assure that good medical services are provided to the citizens of Monroe and surrounding counties. The current Board is made up of a retired local businessman, a pharmacist, a retired banker, a retired banker and farmer, a retired school teacher, a dentist, an optometrist, the chief of the medical staff and the vice chief of the medical staff. Any surplus funds of the Monroe Foundation, Inc. are used to upgrade the building, purchase updated equipment and provide other wellness services and quality healthcare for our community. |
| Schedule H, Part VI, Line 6 | The hospital is managed by Quorum Health Resources, LLC to provide the day-to-day management of the hospital; however, the Board of Directors has the ultimate decision making authority of the hospital. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt |
|---|---|---|---|
| High School Senior Scholarships | 7 | $9,000 | $0 |
| Medical Student Loan Payments | 1 | $28,000 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 | FormAndLineReferenceDesc |
| Explanation | The hospital Board of Directors approve the payment of all the grant and assistance funds. They are monitored by the CEO and CFO after approval by the Board. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Anthony Carter MD | ||||||||||||||
| Physician | $200,000 | $0 | $362,087 | $0 | $0 | $0 | $6,000 | $0 | $3,427 | $0 | $571,514 | $0 | $0 | $0 |
| William M Carter MD | ||||||||||||||
| Physician | $180,000 | $0 | $0 | $0 | $30,350 | $0 | $0 | $0 | $2,564 | $0 | $212,914 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 6 | FormAndLineReferenceDesc |
| Explanation | The agreements with the physicians state that the Monroe County Medical Center will pay the physician a base salary plus incentive compensation in an amount equal to a certain percentage of the excess of the Medical Center's total collections for physician's personally performed professional medical services over the amount of the Physician's salary and overhead expense. | ExplanationTxt |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jack Anderson DO | PersonNm |
| Relationship With Org | Former Board Member and Chief of Medical Staff | RelationshipWithOrgTxt |
| Cash Grant | $28,000 | CashGrantAmt |
| Type Of Assistance | Payment of Medical Student Loan | TypeOfAssistanceTxt |
| Assistance Purpose | Recruitment | AssistancePurposeTxt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Jack Anderson DO | |||
| Former Board of Directors and Chief of Medical Staff | $63,025 | Hospitalist Services and Stress Tests | 0 |
| Jo Ann Brown | |||
| Spouse of CFO | $53,757 | Employee Wages of RN | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 3 | The Monroe Medical Foundation, Inc. has contracted with a management company, Quorum Health Resources, LLC to provide Management services to the hospital. The CEO and CFO are employees of the management company, but they are still under the control of the Board of Directors. The CEO and CFO report to the Board of Directors each month at the Board meetings and other times as necessary. |
| Form 990, Part VI, Section B, Line 11b | The Form 990 is prepared by the CFO and is reviewed with the CEO before it is filed. |
| Form 990, Part VI, Section B, Line 12c | Each member of the Board of Directors and the CEO and CFO completes a conflict of interest questionnaire annually. Any time there is a a conflict of interest with any Board Member on any issue being discussed by the Board of Directors, the Board member who has the conflict abstains from any vote on the issue. |
| Form 990, Part VI, Section B, Line 15 | The process for determining compensation of the CEO and CFO includes a review and approval by Quorum Health Resources, LLC, the management company, and the Board of Directors. Each member of the Board of Directors completes an evaluation of the CEO, and submits it to the Quorum Regional Vice President. The Regional Vice President presents the evaluations and his recommendations to the Board of Directors based on the evaluations and the salary scale of the management company. The Board of Directors approves or disapproves the recommendation of the Quorum Regional Vice President. The CEO completes the evaluation of the CFO and submits it to the Quorum Regional Vice President . The Regional Vice President presents his recommendations to the Board of Directors based on the evaluation and the salary scale of the management company. The Board of Directors approves or disapproves the recommendation of the Quorum Regional Vice President. |
| Form 990, Part VI, Section C, Line 19 | The governing documents, conflict of interest policy and financial statements are available to the public upon request in the Administration office of the Monroe County Medical Center, 529 Capp Harlan Road, Tompkinsville, Kentucky 42167 |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | I prefer not to file the Form 990 before our independent audit is completed and presented to our Board in case there are any adjustments to the financial statements. The independent audit was not completed and presented to our Board by the original due date of July 15, 2017. I filed the Automatic 6 month extension on July 14, 2018 which extended it to January 15, 2019. | ExplanationTxt |
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