2015-08-14T10:29:17-05:00 2014-09-30 BKD LLP 360 E 8TH AVE STE 201 PO BOX 1196 BOWLING GREEN KY 421021196 990 2013-10-01 620988604 MACON HOSPITAL INC % THOMAS J KIDD CPA MACO 6156662147 204 MEDICAL DRIVE Suite LAFAYETTE TN 37083 THOMAS KIDD CFO 6156662147 2015-08-14 true JESSICA FREEMAN P01261457 6156662147 2013 2016-03-07 17:11:31Z DENNIS WOLFORD 204 MEDICAL DRIVE LAFAYETTE TN 37083 12823715 false X WWW.MCGH.NET X 1975 TN THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. 8 8 169 10 0 0 20891 191112 11628973 12247674 15859 13526 485680 371403 12151403 12823715 0 0 0 0 6225261 6264281 0 0 0 6142540 6377412 12367801 12641693 -216398 182022 4794946 5253820 961470 1238322 3833476 4015498 THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. false false 10676237 12261164 TO PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES TO CITIZENS OF MACON COUNTY, TN AND SURROUNDING COUNTIES WITHOUT REGARD TO ABILITY TO PAY, RACE, RELIGION, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, ETC. WE PROVIDE CHRONIC DISEASE MANAGEMENT EDUCATION, COMMUNITY OUTREACH AND HEALTH FAIRS TO OVER 8,399 INDIVIDUALS. PROVIDED $254,000 OF CHARITY CARE FOR YEAR ENDED SEPTEMBER 30, 2014. 10676237 true true false true false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 36 0 true 169 true false false false false false false false false false false X 8 8 false true false false false false false true true false false true true true true true true true true false X THOMAS J KIDD CPA 6156662147 204 MEDICAL DRIVE LAFAYETTE TN 37083 CHARLES DARNELL PRESIDENT 2.0 X X 1200 0 0 LINDA AUSTIN MEMBER 1.0 X 1200 0 0 FEMI ODUNUSI MD MEMBER 1.0 X 2025 0 0 HL GOODALL MEMBER 1.0 X 1100 0 0 HUGH CLARK MEMBER 1.0 X 1200 0 0 FRED SCRUGGS MEMBER 1.0 X 1200 0 0 RADFORD WEST VICE-PRESIDENT 2.0 X X 1100 0 0 STANLEY CHUNN MD SECRETARY / TREASURER 3.0 X X 1400 0 0 THOMAS KIDD CFO 50.0 X 0 0 0 DENNIS WOLFORD CEO 50.0 X 0 0 0 10425 0 0 0 false false true EM CARE PHYSICIAN SVC 7032 COLLECTION CENTER DR CHICAGO IL 60693 PHYSICIAN STAFFING 460789 ALLIANCE IMAGING INC PO BOX 96485 CHICAGO IL 60693 MRI SERVICES 252454 PAINTER HUDSON PHARMACIST 1515 OLD LAKE ROAD RED BOILING SPRINGS TN 37150 PHARMACY COVERAGE 148899 NUCLEAR IMAGING MGMT CORP 1035 HUNTERS HORN GALLATIN TN 37066 IMAGING SERVICES 165948 QHR 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT SERVICES 519050 5 64538 126574 191112 NET PATIENT SERVICE REVENUE 621110 12076967 12076967 OTHER OPERATING 621110 170707 170707 12247674 13526 13526 0 0 38500 38500 0 38500 38500 0 0 0 0 EHR INCENTIVES 900099 314000 314000 RESPITE CARE 624100 9750 9750 MASSAGE/WELLNESS 900099 3740 3740 5413 5413 332903 12823715 12261164 0 371439 0 0 0 0 10425 10425 0 5061895 4256674 805221 80879 67873 13006 767485 644071 123414 343597 288345 55252 182444 182444 0 76105 76105 0 0 0 1721031 1313073 407958 14507 14507 1345093 1208917 136176 0 0 154144 154144 45642 33608 12034 0 0 0 0 419177 419177 224423 224423 BAD DEBTS 1552666 1552666 REPAIRS & MAINTENANCE 257099 213631 43468 DUES & SUBSCRIPTIONS 60964 29529 31435 MEDICAL SUPPLIES 268847 268841 6 55270 1265 54005 12641693 10676237 1965456 0 507437 1024981 1125207 1032972 0 0 1181398 1156462 0 0 0 0 0 0 178533 187404 124137 114051 7052890 5314940 1678234 1737950 0 0 0 0 0 0 0 0 0 0 4794946 5253820 936713 836906 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24757 401416 961470 1238322 X 3833476 4015498 0 0 0 0 3833476 4015498 4794946 5253820 182022 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1008 1008 false SCH C, PART II-B, LINE 1I A PORTION OF THE DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE TENNESSEE HOSPITAL ASSOCIATION ARE FOR LOBBYING. 485487 485487 2176911 2030303 146608 40170 39865 305 4211933 3160631 1051302 138389 84141 54248 1737950 0 DUE TO THIRD PARTIES 401416 401416 11271049 -1552666 -1552666 12823715 12823715 11089027 11089027 1552666 1552666 12641693 SCH D, PART X, LINE 2 INCOME TAXES ------------ The organization's audited financial statements did not include a footnote that addressed the organization's liability for uncertain tax positions under FIN48 (ASC 740). Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review,management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. SCH D, PART XI & XII RECONCILIATION TO AUDIT REPORT ------------------------------ PART XI LINE 2D OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON 990 PART VIII: ------------------------------------------------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT ($1,552,666) PART XII LINE 2D OTHER ITEMS INCLUDED ON 990 PART IX BUT NOT ON LINE 1: ------------------------------------------------------ BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT $1,552,666 true true true X true X 100 false true true false false 254209 254209 0.02290 2291329 2291329 0.20660 2545538 2545538 0.22950 2545538 2545538 0.22950 true 1552666 652120 4672515 4831002 -158487 X false 1 1 MACON HOSPITAL INC 204 MEDICAL DRIVE LAFAYETTE TN 37083 WWW.MCGH.NET X X X MACON HOSPITAL INC true X X X X X X X X X 12 true false true X mcgh.net/CommunityNeedsAssessment.html X X X false false true true 100 true 100 true X X X true true X X X X X true X X false X X X true X false false SCH. H, PART V, SECTION B, LINE 3 COMMUNITY INPUT --------------- INPUT FROM THE COMMUNITY WAS PROVIDED BY: THE STATE OF TENNESSEE DEPARTMENT OF HEALTH, MACON COUNTY GENERAL HOSPITAL, MACON COUNTY SCHOOL SYSTEM, PRIMARY CARE PROVIDERS, UNIVERSITY OF TENNESSEE EXTENSION SERVICE, MACON COUNTY SENIOR CITIZENS CENTER AND LOCAL INDIVIDUALS AND COMMUNITY LEADERS. SCH. H, PART V, SECTION B, LINE 6 IMPLEMENTATION STRATEGY ----------------------- MACON COUNTY'S IMPLEMENTATION STRATEGY CAN BE FOUND AT http://www.mcgh.net/files/Implementation_Plan_2012-2014.docx. SCH. H, PART V, SECTION B, LINE7 HEALTH NEEDS ADDRESSED ---------------------- THE TOP 5 HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT ARE ADDRESSED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN. SCH H, PART III, LINE 4 BAD DEBTS --------- THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. THE AMOUNT REPORTED ON LINE 3 RELATES TO THOSE ACCOUNTS WHERE THE HOSPITAL COULD NOT OBTAIN THE NECESSARY PAPERWORK TO PROPERLY CLASSIFY IT AS CHARITY CARE UNDER THE HOSPITAL POLICIES. SCH H, PART III, LINE 8 COSTING METHODOLOGY ------------------- THE MEDICARE COST REPORT WAS USED TO DETERMINE LINE 6. SCH H, PART VI, LINE 2 NEEDS ASSESSMENT ---------------- MACON COUNTY GENERAL HOSPITAL HAS CONDUCTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT AND WE ARE WORKING WITH LOCAL ORGANIZATIONS AND THE COMMUNITY TO IMPLEMENT THE ASSESSMENT. WE ARE ACTIVELY ENGAGED IN PROVIDING FOR AND IMPROVING THE HEALTH OF OUR COMMUNITY. MACON COUNTY, TENNESSEE HAS A STATISTICALLY HIGH PERCENTAGE OF THE POPULATION WITH DIABETES AND MCGH PROVIDES A DIABETES EDUCATION CENTER TO PROVIDE COOKING CLASSES, NUTRITION EDUCATION AND A QUESTION HOTLINE FOR THE COMMUNITY TO MANAGE THEIR DISEASE. MANAGEMENT OF MCGH ARE ALSO LEADERS AND ORGANIZERS OF THE ANNUAL MAKIN' MACON FIT FITNESS FESTIVAL THAT PROMOTES AN ACTIVE LIFESTYLE THAT IS IN IT'S 21st YEAR. MCGH STAFF WORKS WITH THE MACON COUNTY SCHOOL SYSTEM AND COORDINATED A SCHOOL HEALTH PROGRAM TO PROVIDE CLASSROOM INSTRUCTION ON NUTRITION AND FITNESS TO THE STUDENTS OF THE SCHOOL SYSTEM. MCGH STAFF ARE ON THE BOARDS OF THE SENIOR CITIZEN CENTER, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE UPPER MIDDLE TN RURAL HEALTH NETWORK. THROUGH THESE ORGANIZATIONS, WE LEARN OF AND PROVIDE EDUCATION, TRAINING, SCREENINGS AND OTHER ACTIVITIES TO ASSESS AND IMPROVE THE HEALTH NEEDS OF OUR COMMUNITY. SCH H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ----------------------------------------------- THE REGISTRATION STAFF DESCRIBE AND PROVIDE LITERATURE ABOUT FINANCIAL ASSISTANCE DURING THE PATIENT INTERVIEW PROCESS. EFFORTS ARE MADE TO PUT PATIENTS IN CONTACT WITH RESOURCES AVAILABLE TO ASSIST THE PATIENT IN GETTING QUALIFIED FOR GOVERNMENT OR OTHER ASSISTANCE. APPLICATIONS FOR HOSPITAL CHARITY CARE ARE DISTRIBUTED TO REGISTRARS, BILLING OFFICE STAFF AND A SOCIAL WORKER. POSTED NOTICES ARE OTHER SOURCES OF INFORMATION. SCH H, PART VI, LINE 4 COMMUNITY INFORMATION --------------------- MACON COUNTY, TN HAD A 2010 POPULATION OF 22,248 CITIZENS. THE HOSPITAL SERVES PRIMARILY MACON COUNTY AND PATIENTS CLOSE TO THE BORDER OF MACON COUNTY. THE MEDIAN HOUSEHOLD INCOME IN 2000 WAS $29,867 WITH AN ESTIMATED 15.1% OF THE COUNTY'S POPULATION LIVING IN POVERTY. THE COUNTY COVERS 307 SQUARE MILES AND IS BOTH A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P). SCH H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH ----------------------------- MACON COUNTY GENERAL HOSPITAL'S DEDICATED STAFF VOLUNTEER FOR NUMEROUS CAUSES PROMOTING HEALTH AND WELFARE FOR MACON COUNTY INCLUDING: RELAY FOR LIFE, MAKIN' MACON FIT FITNESS FESTIVAL, MAMMOGRAPHY SCREENINGS, BREAST CANCER AWARENESS EVENTS, SENIOR CITIZENS CENTER EDUCATION AND SCREENINGS, LOCAL RADIO WEEKLY SHOW ON HEALTH ISSUES AND HOW TO TAKE PREVENTATIVE MEASURE, MACON COUNTY CO-ORDINATED SCHOOL HEALTH PROGRAM, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE MACON COUNTY EDUCATION FOUNDATION. THE MEDICAL STAFF IS OPEN TO ANY PHYSICIAN WHO MEETS CREDENTIALING STANDARDS AND AGREES TO STANDARDS ESTABLISHED BY THE MEDICAL STAFF. VARIOUS BUSINESS LEADERS SERVE ON THE BOARD OF DIRECTORS ALONG WITH LEADERS OF THE PHYSICIAN COMMUNITY. SURPLUS FUNDS PROVIDE FOR CONTINUITY OF HEALTHCARE SERVICES DURING PERIODS OF ECONOMIC DOWNTURN AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. X X false false false false false false false false false THOMAS KIDD CFO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DENNIS WOLFORD CEO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCH J, PART II COMPENSATION FROM UNRELATED ORGANIZATION ---------------------------------------- THE HOSPITAL CONTRACTS THE SERVICES OF DENNIS WOLFORD (CEO) AND THOMAS KIDD (CFO) WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.), AN UNRELATED ORGANIZATION. QHR was paid $337,050 for services provided by these individuals for the fiscal year ending September 30, 2014. FORM 990, PART VI, QUESTION 3 DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSON ------------------------------------------------------------- THE HOSPITAL CONTRACTS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.). UNDER TERMS OF THE AGREEMENT, QHR PROVIDES THE SERVICES OF A CEO, CFO, AND ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES CONSISTENT WITH THE POLICIES AND DIRECTIVES DICTATED BY THE BOARD OF DIRECTORS. For fiscal year ending September 30, 2014, Macon County Hospital paid QHR $151,823 for the services of Thomas Kidd (CFO) and $185,227 for the services of Dennis Wolford (CEO). PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THE CEO AND CFO. FORM 990, PART VI, QUESTION 11B PROCESS TO REVIEW THE FORM 990 ------------------------------ A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, QUESTION 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY ------------------------------------------------------------------ ALL EMPLOYEES OF THE HOSPITAL ARE COVERED AND REVIEWED BY THE COMPLIANCE OFFICER. ANY EMPLOYEES HAVING A CONFLICT OF INTEREST ARE NOT ALLOWED TO PARTICIPATE IN THE DECISION MAKING REGARDING ANY ACTIVITY THAT WOULD BE VIEWED AS A CONFLICT OF INTEREST. FORM 990, PART VI, QUESTIONs 15A & 15B PROCESS FOR DETERMINING COMPENSATION ------------------------------------ THE REVIEW IS CONDUCTED BY QHR THAT SHOWS THE MINIMUM, MEDIAN AND MAXIMUM SALARY FOR THE SAME POSITION AT SIMILAR ORGANIZATIONS IN SIZE AND VOLUME. THE BOARD THEN TAKES THIS INFORMATION AND SETS THE SALARY FOR THE CEO AND CFO. FORM 990, PART VI, LINE 19 MAKING DOCUMENTS AVAILABLE TO THE PUBLIC ---------------------------------------- THE ORGANIZATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE STORED IN ADMINISTRATION AND AVAILABLE UPON REQUEST.