2018-11-14T15:01:53-06:00 2017-12-31 540504608 BROWN EDWARDS & COMPANY LLP 1909 FINANCIAL DRIVE HARRISONBURG VA 22801 990 2017-01-01 540505913 BATH COMMUNITY HOSPITAL BATH 5408397000 POST OFFICE DRAWER Z HOT SPRINGS VA 24445 DEBORAH SHIPMAN CFO 5408397000 2018-11-14 1 JAMES R FRIES P01320612 5404346736 2018-11-14 206.248.228.130 2018-11-14 15:57:50 ES P CE530EA759AC3AF6BB0EECEF8950573E07121913 D0156BD46B4B1FE921C9503B1D7FFBF99E37DBAB 2017 2019-02-21 02:37:17Z DEBORAH SHIPMAN POST OFFICE DRAWER Z HOT SPRINGS VA 24445 22575351 0 X WWW.BATHHOSPITAL.ORG X 1925 VA BATH COMMUNITY HOSPITAL ACCEPTS PRIMARY RESPONSIBILITY FOR IMPROVING THE HEALTH OF OUR AREA BY PROVIDING HIGH QUALITY, COMPASSIONATE, AND AFFORDABLE HEALTH CARE TO OUR REGION. 11 10 200 0 0 0 7531190 6966595 14762093 15431889 10428 5613 99820 154424 22403531 22558521 6685 3810227 0 0 10726253 11335338 0 0 0 10520103 10426620 21253041 25572185 1150490 -3013664 28548393 24800749 17958932 17301062 10589461 7499687 TO TAKE PRIMARY RESPONSIBILITY FOR IMPROVING THE HEALTH OF OUR AREA BY PROVIDING HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTH CARE TO OUR REGION. 0 0 21662088 3810227 15576314 BATH COMMUNITY HOSPITAL OPERATES A 25-BED CRITICAL ACCESS HOSPITAL, TWENTY-FOUR HOUR EMERGENCY SERVICES, PRIMARY CARE, AS WELL AS A SELECT RANGE OF DIAGNOSTIC SERVICES, REHABILITATIVE SERVICES AND SPECIALTY CLINICS. IN ADDITION, BATH COMMUNITY HOSPITAL HOLDS VARIOUS EVENTS, FREE OF CHARGE, THROUGHOUT THE YEAR THAT BENEFIT THE HEALTH AND WELLNESS OF THE COMMUNITY. IN 2017, BATH COMMUNITY HOSPITAL SERVED 2,201 CITIZENS THROUGH ITS FREECOMMUNITY HEALTH EDUCATION TOPICS SUCH AS DIABETES EDUCATION, HEART HEALTH, FALL PREVENTION CLASSES, BICYCLE SAFETY, BLOOD PRESSURE SCREENINGS AND HEALTH FAIR ACTIVITIES INCLUDING A BEHAVIORAL HEALTH PRESENTATION. IN ADDITION, BATH COMMUNITY HOSPITAL SERVED 399 PATIENTS THROUGH THEIR CHARITY CARE PROGRAM. 21662088 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 53 0 1 200 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X X THE ORGANIZATION 5408397000 106 PARK DR HOT SPRINGS VA 24445 WILLIAM BRATTON DIRECTOR (JAN-APR) 1.00 0.50 X 0 0 0 RALPH CLARK DIRECTOR 1.00 0.50 X 0 0 0 SCOTT HETZER DIRECTOR 1.00 0.50 X 0 0 0 JOHN LOEFFLER DIRECTOR 1.00 0.50 X 0 0 0 JEFFREY MCCRAY PHYSICIAN 40.00 0.50 X 221419 0 34191 SARAH MCWILLIAMS DIRECTOR 1.00 0.50 X 0 0 0 DASTGIR QURESHI DIRECTOR 1.00 0.50 X 0 0 0 R MEADE SNYDER DIRECTOR 1.00 0.50 X 0 0 0 TIM PISTELL CHAIR 1.00 0.50 X X 0 0 0 GEORGE PHILLIPS VICE CHAIR 1.00 0.50 X X 0 0 0 LAURENS SARTORIS SECRETARY 1.00 0.50 X X 0 0 0 KATHY LANDRETH CEO 40.00 0.50 X 205559 0 25265 GREG GUTMEIR CFO (JAN-MAY) 40.00 0.50 X 60905 0 5981 DEBORAH SHIPMAN CFO (JULY-DEC) 40.00 0.50 X 66165 0 7193 LEVI RIZK PHYSICIAN 40.00 X 267743 0 36346 VERONICA ORTIZ HOSPITALIST (JAN-OCT) 40.00 X 239246 0 18233 DOUG HOLROYD DIR OF PHARMACY 40.00 X 176103 0 25605 KEITH HUMMEL PHYSICIAN 40.00 X 187421 0 26705 JASON PARET FORMER CEO 0.00 X 181751 0 0 JAMES REDINGTON PHYSICIAN (HIGHEST COMP EMP) 0.00 X 199395 0 16174 1805707 0 195693 8 1 1 0 THE ERX GROUP LLC 9724 KINGSTON PIKE KNOXVILLE TN 37922 CONTRACT PHYSICIANS 687440 CPSI PO BOX 850309 MOBILE AL 36685 SOFTWARE SUPPORT AND A/R MANAGEMENT 587559 STAFF CARE INC PO BOX 12140 BURLINGTON NC 27216 CONTRACT PHYSICIANS 218209 TRANE US INC PO BOX 406469 ATLANTA GA 30384 HVAC EQUIP AND MAINTENANCE 182912 SIEMENS MEDICAL SOLUTIONS USA PO BOX 120001 DALLAS TX 75312 MAINTENANCE CONTRACT ON MEDICAL EQUIPMEN 153060 7 2127285 112339 4726971 6966595 OTHER PROFESSIONAL SERVICES 621300 19135613 19135613 DAILY PATIENT SERVICES 621300 2212517 2212517 OTHER NURSING SERVICES 621300 1616961 1616961 CHARITY CARE 621300 -637560 -637560 CONTRACTUAL ADJUSTMENTS 621300 -6895642 -6895642 15431889 13406 13406 19036 9037 9999 9999 9999 7793 -7793 -7793 -7793 MISC CAFETERIA AND DIETARY REVENU 621300 138672 138672 MISCELLANEOUS INCOME 621300 3491 3491 MEDICAL TRANSCRIPTS 621300 2262 2262 144425 22558521 15576314 0 15612 3810227 3810227 626677 255609 371068 181751 181751 8456711 7329965 1126746 327954 284258 43696 1102810 955875 146935 639435 554239 85196 179750 179750 55220 55220 45124 45124 1998187 1481701 516486 69951 4874 65077 154215 132583 21632 144000 29669 114331 369002 357490 11512 48538 43683 4855 248112 248112 1432573 1432573 226095 13921 212174 SUPPLIES 2583788 2555403 28385 PROVISION FOR BAD DEBTS 1409475 1409475 EQUIPMENT RENTAL & MAIN 709333 639841 69492 DUES AND SUBSCRIPTIONS 209429 136333 73096 543828 234369 309459 25572185 21662088 3910097 0 X 3396297 334368 148876 132008 1424914 1409510 225957 185312 585104 495261 429098 437935 33678335 12314560 21834724 21363775 411649 321834 91774 120746 28548393 24800749 1803582 1145712 16155350 16155350 17958932 17301062 X 9194642 6104868 1394819 1394819 0 0 10589461 7499687 28548393 24800749 -3013664 -76110 0 X X 0 1 X 1 0 X 673218 673218 24830188 6935327 17894861 415585 328389 87196 7137250 4669706 2467544 622094 381138 240956 21363775 21169839 20917 20917 21148922 124 1409475 1409599 22558521 20383502 20916 20916 20362586 124 5209475 5209599 25572185 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST RECEIPTS 9,037. OTHER AMOUNTS NETTED ON FINANCIAL STATEMENTS 11,878. ROUNDING 2. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 1,409,475. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST RECEIPTS 9,037. OTHER AMOUNTS NETTED ON FINANCIAL STATEMENTS 11,878. ROUNDING 1. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 1,409,475. TRANSFER TO FOUNDATION 3,800,000. 1 1 1 X 1 X 1 1 1 0 1 1 1 2100 558792 558792 0.02310 1 384 766846 363989 402857 0.01670 2 2484 1325638 363989 961649 0.03980 211 2201 15866 15866 0.00070 4 5690 3931988 2993097 938891 0.03890 28 516 9968 9968 0.00040 243 8407 3957822 2993097 964725 0.04000 245 10891 5283460 3357086 1926374 0.07980 1 450 1000 1000 0.00000 1 300 2500 2500 0.00010 2 750 3500 3500 0.00010 1 1409475 4076451 4352233 -275782 X 1 1 1 1 BATH COMMUNITY HOSPITAL 106 PARK DR HOT SPRINGS VA 24445 WWW.BATHHOSPITAL.ORG H1827 VA X X X X BATH COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X WWW.BATHHOSPITAL.ORG/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X X 1 15 1 WWW.BATHHOSPITAL.ORG/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 1 X 200.000000000000 250.000000000000 X X X 0 1 X X X 1 X WWW.BATHHOSPITAL.ORG X X X X X 1 X 0 X X 1 X 0 0 BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: SINCE THE GREATEST PORTION OF THE ORGANIZATION'S PATIENT AND CUSTOMERS RESIDE IN BATH COUNTY, FOCUS GROUPS, PAPER SURVEYS AS WELL AS AN ONLINE SURVEY WERE UTILIZED TO GATHER INPUT FROM THE COMMUNITY REGARDING COMMUNITY HEALTH NEEDS AND CONCERNS. SPECIAL ATTENTION WAS TAKEN THROUGHOUT THE PRIMARY DATA COLLECTION PROCESS TO ENSURE THE HOSPITAL'S ASSESSMENT TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH. THE FOCUS GROUP MEMBERS INCLUDED REPRESENTATIVES FROM THE MEDICAL COMMUNITY, CIVIC ORGANIZATIONS, BUSINESS OWNERS, FARMERS, PUBLIC HEALTH OFFICIALS, EMTS, FIRE FIGHTERS, CITY AND COUNTY OFFICIALS, SCHOOL PERSONNEL, MENTAL HEALTH PROVIDERS, BATH COUNTY SHERRIFF'S OFFICE PERSONNEL, SUBSTANCE ABUSE AND MENTAL HEALTH COUNSELORS, MINISTERIAL ASSOCIATION MEMBERS, BOARD OF TRUSTEE MEMBERS, HIGH SCHOOL ATHLETES, PATIENTS AND PEOPLE REPRESENTING THE UNINSURED AND UNDERINSURED POPULATION. BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: LOCAL VIRGINIA HEALTH DEPARTMENTBATH COUNTY DEPARTMENT OF SOCIAL SERVICESBATH COUNTY ADMINISTRATIONROCKBRIDGE COUNTY COMMUNITY SERVICESRIVERSIDE HEALTH CENTER BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 7D: FOCUS GROUPS BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: MENTAL HEALTH & SUBSTANCE ABUSE: EXPLORE THE IMPLEMENTATION OF AN INTEGRATED BEHAVIORAL HEALTH PROGRAM IN THE RURAL HEALTH CLINIC. OFFER MENTAL HEALTH FIRST AID CLASS IN THE COMMUNITY. EXPLORE THE USE OF TELE-PSYCHIATRY SERVICES. EXPLORE IMPLEMENTATION OF A SADD (STUDENTS AGAINST DESTRUCTIVE DECISIONS) CLUB. EXERCISE, PREVENTION & EDUCATION: DEVELOP A ROBUST COMMUNITY HEALTH OUTREACH PROGRAM.CHRONIC DISEASE MANAGEMENT IN AN AGING POPULATION: EXPLORE OPPORTUNITY OF PATIENT NAVIGATOR POSITION. PARTNER WITH PRIMARY CARE PROVIDERS.NEEDS NOT BEING ADDRESSED AND WHY: WHILE ALL IDENTIFIED NEEDS ARE IMPORTANT, BATH COMMUNITY HOSPITAL WILL NOT ADDRESS THE NEED FOR PUBLIC TRANSPORTATION IN BATH COUNTY. ALSO, DIALYSIS WILL NOT BE PURSUED AS IT IS NOT CONSIDERED AN UNDERSERVED NEED AS ACCESS TO DIALYSIS CENTERS IS AVAILABLE IN THE NEIGHBORING COMMUNITIES, INCLUDING LOW MOOR AND LEXINGTON, VA. BATH COMMUNITY HOSPITAL PART V, SECTION B, LINE 20E: NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE, AND IN COMMUNICATIONS WITH THE INDIVIDUALS REGARDING THEIR BILL. 1 1 - BATH COMMUNITY REHAB & WELLNESS CENTER PO DRAWER Z HOT SPRINGS VA 24445 WELLNESS SERVICES, WHICH ARE COHOUSED WITH LICENSED REHAB SERVICES PART I, LINE 3C: WE ALSO CONSIDER ASSETS SUCH AS MONEY IN THE BANK AND ASSETS THAT COULD BE LIQUIDATED INTO CASH, AND WE REVIEW BANK STATEMENTS TO SEE IF MONEY IS FREQUENTLY SPENT ON LUXURY ITEMS INSTEAD OF NEEDED ITEMS. PART I, LINE 7: ALL FIGURES ARE DERIVED FROM THE FINANCIAL STATEMENTS, WHICH ARE PREPARED ON THE INCOME TAX BASIS. THE COST TO CHARGE RATIO FROM WORKSHEET 2 IS USED. THE DIFFERENCES BETWEEN AMOUNTS REPORTED IN TAX YEAR 2016 AND TAX YEAR 2017 REFLECT THE HOSPITAL'S IMPROVED ACCESS TO DATA AND CORRESPONDING ANALYTICS IN TAX YEAR 2017. 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 $ 1,409,475. PART II, LINE 3 BATH COMMUNITY HOSPITAL IS A COMMUNITY SUPPORTER OF THE ALLEGHANY HIGHLANDS BIKE RODEO. BATH COMMUNITY HOSPITAL PURCHASES 300 BICYCLE HELMETS WHICH ARE GIVEN AWAY AT THE EVENT. IN ADDITION, BCH ALSO PROVIDES BICYCLE SAFETY INFORMATION TO OVER 450 PARTICIPANTS IN ATTENDANCE. THIS EVENT IS FREE AND OPEN TO THE PUBLIC. PART II, LINE 9 BATH COMMUNITY HOSPITAL IS A GOLD SPONSOR OF THE BATH COUNTY TRIATHLON. THIS TRIATHLON IS HELD IN BATH COUNTY AND HAS AT LEAST 300 PARTICIPANTS. THIS EVENT ENCOURAGES OUR COMMUNITY TO TRAIN, GET ACTIVE AND OFFERS SEVERAL DIFFERENT PARTICIPATION LEVELS. IN ADDITION, OUR WELLNESS CENTER ALSO OFFERS A TRIATHLON TRAINING PROGRAM TO HELP PARTICIPANTS PREPARE FOR THE EVENT. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. BALANCES ARE CONSIDERED DELINQUENT WHEN THEY ARE OUTSTANDING FOR 90 DAYS WITH NO ACTIVITY AT WHICH TIME THE BALANCES ARE TRANSFERRED TO A COLLECTION AGENCY AND THE BALANCE IS MOVED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. THE BAD DEBT EXPENSE REPORTED ON SCH H, PART III, LINE 2 IS THE ESTIMATED BAD DEBT ATTRIBUTABLE TO CHARGES ON PATIENT ACCOUNTS. PART III, LINE 8: NONE SHOULD BE TREATED AS A COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS AS DETERMINED BY FILING OF THE CMS 2552-10 COST REPORT. PART III, LINE 9B: ONCE ELIGIBILITY FOR FINANCIAL ASSISTANCE HAS BEEN DETERMINED, THE BILLS ARE ADJUSTED FOR PATIENTS WHO QUALIFY. 0 BATH COMMUNITY HOSPITAL FOUNDATION PO DRAWER Z HOT SPRINGS VA 24445 571137401 501(C)3 3800000 CASH TRANSFER OF FUNDS - THE HOSPITAL IS A NAMED PERPETUAL BENEFICIARY OF THE LETTIE PATE EVANS TRUST. AS A NAMED BENEFICIARY, THE HOSPITAL RECEIVES SUBSTANTIAL SUPPORT ON AN ANNUAL BASIS. IN DECEMBER 2017, THE BOARD OF THE HOSPITAL CHOSE TO BEGIN PASSING THIS CONTRIBUTION TO THE FOUNDATION. THE INTENT OF THIS DECISION IS TO GROW THE FOUNDATION TO ENSURE CONTINUED AND LONG TERM SUPPORT OF THE HOSPITAL. 1 X X X 0 0 0 0 0 0 0 0 0 JEFFREY MCCRAY PHYSICIAN 219135 0 2284 0 0 0 10417 0 23774 0 255610 0 0 0 KATHY LANDRETH CEO 186909 0 18650 0 0 0 9598 0 15667 0 230824 0 0 0 LEVI RIZK PHYSICIAN 244394 0 23349 0 0 0 12572 0 23774 0 304089 0 0 0 VERONICA ORTIZ HOSPITALIST (JAN-OCT) 239246 0 0 0 0 0 11490 0 6743 0 257479 0 0 0 DOUG HOLROYD DIR OF PHARMACY 172453 0 3650 0 0 0 8343 0 17262 0 201708 0 0 0 KEITH HUMMEL PHYSICIAN 187271 0 150 0 0 0 0 0 26705 0 214126 0 0 0 JASON PARET FORMER CEO 181751 0 0 0 0 0 0 0 0 0 181751 0 181751 0 JAMES REDINGTON PHYSICIAN (HIGHEST COMP EMP) 199395 0 0 0 0 0 924 0 15250 0 215569 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE BYLAWS GIVE THE EXECUTIVE COMMITTEE FULL AUTHORITY TO OPERATE AND ADMINISTER THE CORPORATION BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND TO ACT IN ALL SITUATIONS EXCEPT AS SPECIFIED IN THE CORPORATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B ALL MEMBERS OF THE BOARD REVIEW A COPY OF THE 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM IS SIGNED ANNUALLY BY ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR OF HUMAN RESOURCES USES YAFFE & COMPANY TO ASSIST WITH EXECUTIVE COMPENSATION QUESTIONS FROM THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ALSO USE THE VASHHRA REPORT FOR SALARY SURVEY PURPOSES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART X, LINE 14 TOTAL ASSETS AS REPORTED ON THIS RETURN DIFFER FROM THE AUDITED FINANCIAL STATEMENTS DUE TO SEPARATE REPORTING OF NET LOAN ISSUANCE COSTS OF $411,649. ON THE FINANCIAL STATEMENTS, THESE COSTS ARE NETTED AGAINST THE LIABILITY BALANCE. FORM 990, PART XII, LINE 1 THE ORGANIZATION USES INCOME TAX BASIS OF ACCOUNTING. THAT BASIS DIFFERS FROM GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRIMARILY BECAUSE THE HOSPITAL DOES NOT RECORD, AS A PERMANENTLY RESTRICTED ASSET, FUNDS HELD IN TRUST BY OTHERS. THE HOSPITAL ALSO DOES NOT RECORD ITS LONG-TERM INVESTMENTS AND BENEFICIAL INTERESTS AT FAIR VALUE AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE ORGANIZATION DID NOT CHANGE ITS ACCOUNTING METHOD IN CURRENT YEAR. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SELECTION OF AN AUDIT COMMITTEE THAT OVERSEES PREPARATION OF FINANCIAL STATEMENTS AND AUDIT PROCESS. THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS IN CURRENT YEAR. BATH COMMUNITY HOSPITAL FOUNDATION PO DRAWER Z HOT SPRINGS VA 24445 571137401 SUPPORT FUNDRAISING EFFORTS OF BATH COMMUNITY HOSPITAL VA 501(C)(3) LINE 12C, III-FI BATH COMMUNITY HOSPITAL 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 BATH COMMUNITY HOSPITAL FOUNDATION B 3800000 CASH BATH COMMUNITY HOSPITAL FOUNDATION C 2127285 CASH