TRIGG COUNTY HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- TRIGG COUNTY HOSPITAL INC (EIN 61-0471581)
- Tax period
- 2015-05-01 to 2016-04-30
- Filed
- 2017-03-17
- IRS object ID
- 201740769349300224
- Schema version
- 2015v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-03-17T13:29:15-04:00 | ReturnTs |
| Tax Period End | 2016-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 E 8TH AVE STE 201 PO BOX 1196 | AddressLine1Txt |
| City | BOWLING GREEN | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 421021196 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610471581 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRIGG COUNTY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % NACY BUTTS | InCareOfNm |
| Business Name Control | TRIG | BusinessNameControlTxt |
| Phone | 2705223215 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 254 MAIN ST | AddressLine1Txt |
| City | CADIZ | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42211 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN SUMNER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2705223215 | PhoneNum |
| Signature | 2017-03-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIM SCIFRES | PreparerPersonNm |
| PTIN | P01316095 | PTIN |
| Phone | 2707810111 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN SUMNER CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 254 MAIN ST | AddressLine1Txt |
| City | CADIZ | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,761,481 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TRIGGHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1952 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AND COST-EFFECTIVE MANNER. WE PLEDGE TO MEET Standards OF EXCELLENCE AND IMPROVE THE VALUE OF OUR SERVICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 250 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $653,754 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,508,312 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,967,984 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,148,134 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,654 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,207 | CYInvestmentIncomeAmt |
| PY Other Revenue | $162,426 | PYOtherRevenueAmt |
| CY Other Revenue | $99,021 | CYOtherRevenueAmt |
| PY Total Revenue | $15,791,818 | PYTotalRevenueAmt |
| CY Total Revenue | $18,759,674 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,619,059 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,129,404 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,957,366 | PYOtherExpensesAmt |
| CY Other Expenses | $8,499,349 | CYOtherExpensesAmt |
| PY Total Expenses | $15,576,425 | PYTotalExpensesAmt |
| CY Total Expenses | $16,628,753 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $215,393 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,130,921 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,140,337 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,973,912 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,238,142 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,541,125 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,902,195 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,432,787 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AND COST-EFFECTIVE MANNER. IN ACHIEVING OUR MISSION, WE PLEDGE TO MEET STANDARDS OF EXCELLENCE WHILE CONTINUOUSLY IMPROVING THE VALUE OF OUR SERVICE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,948,691 | ExpenseAmt |
| Revenue | $16,154,933 | RevenueAmt |
| Desc | OUR MISION IS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AN COST-EFFECTIVE MANNER. IN ACHIEVING OUR MISSION, WE PLEDGE TO MEET STANDARDS OF EXCELLENCE WHILE CONTINUOUSLY IMPROVING THE VALUE OF OUR SERVICE. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO PATIENTS IN THE TRIGG COUNTY, KENTUCKY AREA. | Desc |
| Total Program Service Expenses | $14,948,691 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 250 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NACY BUTTS | PersonNm |
| Phone | 2705223215 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 254 MAIN STREET | AddressLine1Txt |
| City | CADIZ | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 |
|---|---|---|---|---|---|---|---|---|
| JOE NICHOLS | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG FOWLER | ||||||||
| Part-Year BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTY OLIPHANT | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CLARA BETH HYDE | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL GROSS DMD | ||||||||
| CHAIRMAN | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| WILLIAM ANDERSON MD | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MELISSA HALE | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BOB NOEL | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE RADFORD | ||||||||
| SECRETARY/TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEPHANIE PERRY | ||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOE POWELL | ||||||||
| Part-Year BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MIKE WRIGHT | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MALLORY LAWRENCE | ||||||||
| Part-Year BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JESSE THOMAS | ||||||||
| Part-Year BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JOHN SUMNER | ||||||||
| CEO | 40.0 | 0.0 | $82,203 | $0 | $2,466 | Yes (X) | ||
| Alisa Coleman | ||||||||
| Part-Year CEO | 40.0 | 0.0 | $109,733 | $0 | $3,292 | Yes (X) | ||
| DAVID RUTLAND | ||||||||
| PHARMACIST | 40.0 | 0.0 | $132,545 | $0 | $3,974 | Yes (X) | ||
| Holly McCormick | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $116,295 | $0 | $3,489 | Yes (X) | ||
| Karen Miracle | ||||||||
| DIRECTOR OF REHAB | 40.0 | 0.0 | $98,732 | $0 | $2,962 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $539,508 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $16,183 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALIGN MD | |||||
| 5121 MARYLAND WAY SUITE 300 | BRENTWOOD | TN | 37027 | ER PHYSICIAN | $787,056 |
| BLUEGRASS PHYSICIANS LLP | |||||
| PO BOX 674579 | DETROIT | MI | 48267 | ER PHYSICIAN | $766,864 |
| CARDINAL HEALTH 110 INC | |||||
| 5279 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | DRUGS & SUPPLIES | $382,244 |
| CPSI INC | |||||
| 6600 WALL STREET | MOBILE | AL | 36695 | SOFTWARE & BILLING | $296,012 |
| DIAMOND HEALTHCARE CORPORATION | |||||
| PO BOX 85050 | RICHMOND | VA | 23285 | BEHAVIORAL & CP CONS | $255,614 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,497,812 | GovernmentGrantsAmt |
| All Other Contributions | $10,500 | AllOtherContributionsAmt |
| Total Contributions | $2,508,312 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $15,906,705 | $15,906,705 |
| 340B PROGRAM REVENUE | 621110 | $237,624 | $237,624 |
| EHR INCENTIVE | 900099 | $3,805 | $3,805 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,148,134 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,207 | TotalRevenueColumnAmt |
| Exclusion | $4,207 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $42,128 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,807 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $40,321 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,321 | TotalRevenueColumnAmt |
| Exclusion | $40,321 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| LIFE LINE | 900099 | $6,799 | $6,799 | |
| CAFETERIA | 722210 | $40,128 | $40,128 | |
| ALL OTHER MISC REVENUE | 900099 | $11,773 | $11,773 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $58,700 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,759,674 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,154,933 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $96,429 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,694 | TotalAmt |
| Management And General | $197,694 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,609,325 | TotalAmt |
| Program Services | $6,446,173 | ProgramServicesAmt |
| Management And General | $163,152 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,322,385 | TotalAmt |
| Program Services | $1,226,373 | ProgramServicesAmt |
| Management And General | $96,012 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,532 | TotalAmt |
| Management And General | $163,532 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,977 | TotalAmt |
| Management And General | $36,977 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,299 | TotalAmt |
| Program Services | $2,299 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,926,151 | TotalAmt |
| Program Services | $3,845,479 | ProgramServicesAmt |
| Management And General | $80,672 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,687 | TotalAmt |
| Program Services | $30,687 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $712,111 | TotalAmt |
| Program Services | $689,225 | ProgramServicesAmt |
| Management And General | $22,886 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,071 | TotalAmt |
| Program Services | $333,635 | ProgramServicesAmt |
| Management And General | $13,436 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,118 | TotalAmt |
| Program Services | $7,438 | ProgramServicesAmt |
| Management And General | $22,680 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,078 | TotalAmt |
| Program Services | $244,078 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,041,646 | TotalAmt |
| Program Services | $1,041,646 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,986 | TotalAmt |
| Management And General | $251,986 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $739,976 | $733,352 | $6,624 |
| ACCOUNTING COLLECTIONS | $243,859 | $243,859 | |
| MAINTENANCE & REPAIR | $274,137 | $274,137 | |
| PROVIDER TAX | $120,816 | $120,816 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,905 | TotalAmt |
| Program Services | $227,490 | ProgramServicesAmt |
| Management And General | $106,415 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,628,753 | TotalAmt |
| Program Services | $14,948,691 | ProgramServicesAmt |
| Management And General | $1,680,062 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $199,494 | BOYAmt |
| EOY | $373,488 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,580 | BOYAmt |
| EOY | $128,228 | 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 | $2,672,970 | BOYAmt |
| EOY | $2,869,079 | 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 | $2,150 | BOYAmt |
| EOY | $2,364 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,018 | BOYAmt |
| EOY | $151,845 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,674 | BOYAmt |
| EOY | $120,602 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,172,324 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,390,703 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,857,451 | BOYAmt |
| EOY | $10,781,621 | 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 | $0 | BOYAmt |
| EOY | $546,685 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,140,337 | BOYAmt |
| EOY | $14,973,912 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,685,293 | BOYAmt |
| EOY | $1,779,721 | 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 | $8,105,967 | BOYAmt |
| EOY | $8,761,404 | 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 | -$553,118 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,238,142 | BOYAmt |
| EOY | $10,541,125 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,083,955 | BOYAmt |
| EOY | $5,083,955 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,181,760 | BOYAmt |
| EOY | -$651,168 | 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 | $2,902,195 | BOYAmt |
| EOY | $4,432,787 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,140,337 | BOYAmt |
| EOY | $14,973,912 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,130,921 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$600,329 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Belongs Afflt Grp | Yes (X) | OrganizationBelongsAffltGrpInd |
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,299 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,299 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH. C, PART II-B, LINE I | FormAndLineReferenceDesc |
| Explanation | LOBBY EXPENSES -------------- A PORTION OF THE ORGANIZATION'S KHA & AHA DUES ARE USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $66,000 | OtherCostOrOtherBasisAmt |
| Book Value | $66,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,039,311 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,540,400 | DepreciationAmt |
| Book Value | $3,498,911 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $130,670,013 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,850,303 | DepreciationAmt |
| Book Value | $7,216,710 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $10,781,621 | TotalBookValueLandBuildingsAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 100 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $234,865 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $248,560 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,408,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,793,736 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,615,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09710 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,643,815 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,042,296 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,615,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09710 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,643,815 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,042,296 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,615,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09710 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,570,888 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $6,047,691 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,139,981 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$92,290 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| 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 | TRIGG COUNTY HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 254 MAIN STREET | AddressLine1Txt |
| City | CADIZ | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 42211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRIGG COUNTY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://TRIGGHOSPITAL.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://TRIGGHOSPITAL.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 100 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LILNE 5 | CHNA COMMUNITY INPUT -------------------- TRIGG COUNTY SENT A CHNA SURVEY OUT TO THE LOCAL POPULATION FOR ANY RESIDENT TO COMPLETE. 131 RESPONSES TO THIS SURVEY WERE RECEIVED FROM AREA RESIDENTS. IN ADDITION, Trigg County Hospital uilized a CHNA steering committee comprised of 11 key stakeholders in the community. Steering committee members and additional members of the public participated in 3 focus groups as part of the CHNA. |
| PART V, LINE 11 | CHNA NEEDS ADDRESSED -------------------- TRIGG COUNTY Hospital developed an implementation strategy for 2017 through 2019 as part of it's 2016 CHNA. Strategies to address identified needs include: 1. Increase community awareness and knowledge of the new terminology, slang and signs of substance abuse. 2. Decrease the use of chronically prescribed scheduled drugs and illegal drugs in the adult population and address the underlying need for the prescribed medications. 3. Increase the communitys knowledge and awareness of the available mental health services in Trigg and surrounding 4. Increase the awareness of diabetes, heart disease, cancer and obesity and the resources available in Trigg 5. Increase the services available at Trigg County Hospital. |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 | COST OF CHARITY CARE -------------------- COST OF CHARITY CARE WAS CALCULATED WTIH A COST TO CHARGE RATIO USING WORKSHEET 2. COST OF MEDICAID WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. |
| PART III, LINE 8 | COSTING -------- TRIGG COUNTY HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED FROM MEDICARE AT 101% OF COST RELATED TO CARING FOR MEDICARE PATIENTS. MEDICARE REVENUES AND COSTS REPORTED ON LINES 5 AND 6 ARE BASED ON THE MEDICARE COST REPORT. |
| PART III, LINE 9B | DEBT COLLECTION --------------- THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE OR FINANCIAL ASSISTANCE. |
| PART VI, LINE 2 | NEEDS ASSESSMENT ---------------- TRIGG COUNTY HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT WHICH WAS ADOPTED BY THE BOARD OF DIRECTORS during 2016. TRIGG COUNTY HOSPITAL IS ALWAYS WILLING AND AVAILABLE TO MEET THE NEEDS OF THE COMMUNITY AS THEY ARISE. ADDITIONALLY, TRIGG COUNTY HOSPITAL ASSISTS OTHER AGENCIES, AS NEEDED, TO MEET THE HEALTH AND WELFARE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ----------------------------------------------- UNINSURED AND UNDERINSURED PATIENTS ARE PROVIDED WITH INFORMATION ABOUT THE CHARITY CARE PROGRAM. TRIGG COUNTY HOSPITAL CONTRACTS WITH DISABILITY MEDICAL CONSULTANTS (DMC) TO CONTACT EACH OF THESE IDENTIFIED PATIENTS AND PROVIDE THEM WITH INFORMATION ON HOW TO GET QUALIFIED FOR MEDICAID OR HOW TO ENROLL IN INSURANCE PROGRAMS AVAILABLE THROUGH THE AFFORDABLE CARE ACT. |
| PART VI, LINE 4 | COMMUNITY INFORMATION --------------------- TRIGG COUNTY, KENTUCKY IS A RURAL COMMUNITY WITH A POPULATION ESTIMATED AT 14,142. TRIGG COUNTY IS LOCATED IN WESTERN KENTUCKY JOINING THE LAND BETWEEN THE LAKES INCLUDING LAKE BARKLEY AND KENTUCKY LAKE. DUE TO OUR LOCATION, TRIGG COUNTY IS A GREAT RETIREMENT COMMUNITY AND AS SUCH APPEALS TO MANY PEOPLE ACROSS THE COUNTRY. APPROXIMATELY 21.2% OF TRIGG COUNTIANS ARE AGE 65 AND OLDER. TRIGG COUNTY HAS BEEN DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P). THE MEDIAN HOUSEHOLD INCOME IS RIGHT AT THE AVERAGE FOR KENTUCKIANS (APPROXIMATELY $45K); HOWEVER, WELL BELOW THE AVERAGE FOR THE UNITED STATES AT APPROXIMATELY $54K. FINALLY, APPROXIMATELY 21% OF TRIGG COUNTIANS ARE UNINSURED. |
| PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH ----------------------------- TRIGG COUNTY HOSPITAL'S DEDICATED STAFF VOLUNTEER FOR NUMEROUS CAUSES PROMOTING HEALTH AND WELFARE FOR TRIGG COUNTIANS INCLUDING: RELAY FOR LIFE, BREAST IMAGING LUNCH & LEARN, HEART HEALTH LUNCH & LEARN, BREAST IMAGING PRESENTATIONS, KIDS HEALTH FAIR, BREAST CANCER AWARENESS EVENTS, OSTEOPOROSIS SCREENINGS, BACK TO SCHOOL SCREENINGS AND BEHAVIORAL HEALTH TRANSPORTATION. ADDITIONALLY, HOSPITAL STAFF ARE INVOLVED IN SUMMER HEALTH CAMP, COMMUNITY READER DAYS, CHILDREN'S CHRISTMAS TREE DECORATING, TEACHERS BACK TO SCHOOL BREAKFAST, MEET & GREET TEACHERS & PARENTS NIGHT, COMMUNITY EDUCATION ADVISORY COUNCIL, BETA NU AND THE TRIGG COUNTY CHAMBER OF COMMERCE. TRIGG COUNTY HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS WHO ARE COMMITTED TO THE HEALTH AND WELFARE OF THE COMMUNITY AND DEDICATED TO ENSURING THE VIABILITY OF THE HOSPITAL FOR YEARS TO COME. THE BOARD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK AND SERVES EVERYONE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL RESEARCHES AND COMPLETES NUMEROUS GRANT APPLICATIONS APPLICABLE TO PROMOTING THE HEALTH OF OUR COMMUNITY. |
| PART V, LINE 22 | AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS ------------------------------------------- PATIENTS QUALIFYING FOR DSH HAVE THEIR STAY WRITTEN OFF. THOSE THAT DO NOT ARE CHARGED FOR THE CARE AND HAVE THE OPTION TO SET UP A PAYMENT PLAN IF NEEDED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part IV, LINE 20B | Reason not attaching a copy of its Audited Financial Statements ---------------------------------------------------------------- Audited financial statements have not been issued for the year ending 4/30/16 as of the filing date of this return. IRS Form 990 will be amended to attach the audited financial statements to the return as soon as they are issued. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990 ------------------- A COPY OF THE FORM 990 WAS NOT PROVIDED TO THE BOARD BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING OF THE CONFLICT OF INTEREST POLICY --------------------------------------------- THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. ALL EMPLOYEES, STAFF, OFFICERS AND BOARD MEMBERS ARE COVERED BY THIS POLICY. EACH YEAR, THE BOARD MEMBERS ARE ASKED TO SIGN A CONFLICT OF INTEREST STATEMENT. THE HOSPITAL HAS POLICIES AND PROCEDURES IN PLACE THAT WILL BE FOLLOWED SHOULD A CONFLICT OF INTEREST ARISE. A RECORD OF THE PROCEEDINGS WHERE CONFLICTS ARE ADDRESSED IS KEPT ON FILE ONCE REVIEWED. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | PROCESS FOR DETERMINING COMPENSATION ------------------------------------ BOARD OF DIRECTORS REVIEWS THE CEO COMPENSATION ANNUALLY. THESE REVIEWS OF EMPLOYEES ARE DONE ANNUALLY BY THEIR SUPERVISOR OR UPPER MANAGEMENT. THE DATE OF COMPLETION DEPENDS ON THE EMPLOYEES ANNIVERSARY DATE. |
| FORM 990, PART VI, SECTION C, LINE 19 | MAKING DOCUMENTS AVAILABLE TO THE PUBLIC ---------------------------------------- A LEGAL AD IS PUBLISHED ANNUALLY TO ADVISE OF THE AVAILABILITY OF AUDITED FINANCIAL STATEMENTS AT THE HOSPITAL. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL PURCHASED SERVICES TOTAL FEES:3926151 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TRIGG COUNTY HOSPITAL FOUNDATION INC | ||||||||||
| 254 MAIN STREET | CADIZ | KY | 42211 | 061805018 | EDUCATION | KY | 501(c)(3) | 7 | NA | false |
| TRIGG COUNTY PUBLIC HOSPITAL CORPORATION | ||||||||||
| PO BOX 672 | CADIZ | KY | 42211 | 611336530 | GOV UNIT | KY | 501(a) | N/A | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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