PINEVILLE COMMUNITY HOSPITAL ASSOC INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PINEVILLE COMMUNITY HOSPITAL ASSOC INC (EIN 61-0541901)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2014-11-13
- IRS object ID
- 201413179349303646
- Schema version
- 2013v3.0
- 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 | 2014-11-13T13:43:28-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 610420207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JONES NALE & MATTINGLY PLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 642 SOUTH FOURTH ST STE 300 | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610541901 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINEVILLE COMMUNITY HOSPITAL ASSOC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PINE | BusinessNameControlTxt |
| Phone | 6063373051 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 RIVERVIEW AVENUE | AddressLine1 |
| City | PINEVILLE | City |
| State | KY | State |
| ZIP Code | 40977 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | J MILTON BROOKS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6063373051 | PhoneNum |
| Signature | 2014-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID R PRICE | PreparerPersonNm |
| PTIN | P01272254 | PTIN |
| Phone | 5025830248 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | J MILTON BROOKS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 RIVERVIEW AVENUE | AddressLine1 |
| City | PINEVILLE | City |
| State | KY | State |
| ZIP Code | 40977 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,515,669 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PINEVILLEHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE, WITHIN OUR MEANS, QUALITY HEALTH CARE TO THE PEOPLE OF SOUTHEAST KENTUCKY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 343 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $182,108 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$8,294 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,800,925 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,337,289 | CYProgramServiceRevenueAmt |
| PY Investment Income | $262,450 | PYInvestmentIncomeAmt |
| CY Investment Income | $146,575 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,491,332 | PYOtherRevenueAmt |
| CY Other Revenue | $1,031,805 | CYOtherRevenueAmt |
| PY Total Revenue | $27,554,707 | PYTotalRevenueAmt |
| CY Total Revenue | $27,515,669 | 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 | $16,899,129 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,911,748 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,042,231 | PYOtherExpensesAmt |
| CY Other Expenses | $15,031,552 | CYOtherExpensesAmt |
| PY Total Expenses | $31,941,360 | PYTotalExpensesAmt |
| CY Total Expenses | $29,943,300 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,386,653 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,427,631 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,908,705 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,312,760 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,644,847 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,042,406 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,263,858 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,270,354 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE, WITHIN OUR MEANS, QUALITY HEALTH CARE TO THE PEOPLE OF SOUTHEAST KENTUCKY. VALUES: THE STAFF OF PINEVILLE COMMUNITY HOSPITAL IS GUIDED BY THE FOLLOWING VALUES:A. RESPECT - WE WILL RECOGNIZE THE WORTH, DIGNITY, QUALITY AND IMPORTANCE OF EACH OTHER, THE PEOPLE WE SERVE AND THE INSTITUTION.B. QUALITY - CONTNUOUS IMPROVEMENTS IN ALL ASPECTS OF HEALTHCARE PROVIDED IS AN ATTITUDE WHICH MUST BE OUR NUMBER ONE PRIORITY.C. TEAM WORK - EACH OF US IS AN IMPORTANT PART OF THE TEAM; BY WORKING TOGETHER, OUR GOALS CAN BE ACHIEVED.D. COST EFFECTIVENESS - AN IMPORTANT DIMENSION OF QUALITY IS THE COST EFFECTIVENESS OF THE SERVICE WE OFFER; EACH OF THE TEAM MEMBERS IS COMMITTED TO THE WISE USE OF THE RESOURCES AVAILABLE.VISION: PINEIVLLE COMMUNITY HOSPITAL WILL BE PROVIDING TOP QUALITY ACUTE, OUTPATIENT, LONG TERM CARE (SNF) AND HOME HEALTH CARE WHILE MAINTAINING FINANCIAL STABILITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,555,011 | ExpenseAmt |
| Revenue | $22,664,766 | RevenueAmt |
| Desc | ACUTE CARE SERVICES; THE HOSPITAL IS LOCATED IN RURAL SOUTHEAST KENTUCKY WHICH IS IN THE HEART OF THE APPALACHIAN POVERTY BELT. THE HOSPITAL IS AN APPROVED DISPROPORTIONATE SHARE HOSPITAL (DSH) THAT PROVIDES EACH YEAR MORE CARE THAN IS REQUIRED TO QUALIFY FOR THE MAXIMUM DSH LEVELS. THE HOSPITAL ALSO SERVES A HIGH PERCENTAGE OF MEDICARE AND MEDICAID PATIENTS. THE HOSPITAL IS LICENSED FOR 120 ACUTE BEDS AND PROVIDED 9,343 DAYS OF CARE TO THE TRI-COUNTY REGION OF SOUTHEAST KY DURING THE YEAR. 6,579 DAYS OF CARE WERE PROVIDED TO MEDICARE PATIENTS (70%) AND 1,550 DAYS WERE TO MEDICAID PATIENTS (17%). THE HOSPITAL PROVIDED 516 DAYS OF CHARITY CARE DURING THE YEAR ENDED JUNE 30, 2014. THE HOSPITAL ALSO HAD 522 BAD DEBT DAYS DURING THE YEAR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,935,366 | ExpenseAmt |
| Revenue | $3,380,970 | RevenueAmt |
| Desc | LONG TERM CARE (SNF) UNIT - THE HOSPITAL IS LICENSED FOR 30 SKILLED BEDS. SNF PROVIDED 9,330 DAYS OF CARE TO THE TRI COUNTY ARE OF SOUTHEASTERN KY IN FYE JUNE 30, 2014. THE SNF UNIT PROVIDED 460 CHARITY CARE DAYS DURING THE YEAR. THE SNF UNIT HAD 411 BAD DEBT DAYS OF CARE DURING THE YEAR ENDED JUNE 30, 2014. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $635,357 | ExpenseAmt |
| Revenue | $908,007 | RevenueAmt |
| Desc | HOME HEALTH AGENCY - THE HOSPITAL IS LICENSED TO SERVE BELL COUNTY. DURING THE YEAR, THE HOME HEALTH AGENCY PROVIDED 7,662 HOME HEALTH VISITS TO BELL COUNTY RESIDENTS. 378 OF THOSE VISITS WERE CHARITY CARE AND 337 WERE BAD DEBT VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $25,125,734 | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | 0 | 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 | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 343 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | Yes (1) | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLAN KELLY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6063373051 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 RIVERVIEW ROAD | AddressLine1 |
| City | PINEVILLE | City |
| State | KY | State |
| ZIP Code | 409771430 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JOHN G HOWARD | |||||||
| CHAIRMAN/DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAY STEELE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN JONES | |||||||
| SECRETARY/DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHARLES BISHOP | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MANSFIELD DIXON DMD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID GRAMBREL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JERRY WOOLUM MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TALMADGE HAYS MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EMANUEL RADER MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN COMBS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALBEN BROCK | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| J MILTON BROOKS | |||||||
| CEO/DIRECTOR | 40.00 | $246,054 | $0 | $17,928 | Yes (X) | ||
| COLAN A KELLY | |||||||
| CFO | 40.00 | $95,651 | $0 | $14,892 | Yes (X) | ||
| UYI-OGHOSA IDEMUDIA | |||||||
| DOCTOR | 40.00 | $219,759 | $0 | $8,989 | Yes (X) | ||
| LINDA SCEARSE | |||||||
| CRNA | 40.00 | $174,532 | $0 | $4,541 | Yes (X) | ||
| WILLIAM GAUNT | |||||||
| DOCTOR | 40.00 | $244,355 | $0 | $4,541 | Yes (X) | ||
| MICHAEL PETERSON | |||||||
| DOCTOR | 40.00 | $168,566 | $0 | $12,942 | Yes (X) | ||
| RHONDA KECK | |||||||
| CRNA | 40.00 | $173,601 | $0 | $12,942 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,322,518 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $76,775 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SODEXHO | |||||
| 4880 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | FOOD SERVICE | $1,052,361 |
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | MIS VENDOR | $565,838 |
| MARSHALL MEDICAL MANAGEMENT | |||||
| 1792 ALYSHEBA WAY | LEXINGTON | KY | 40509 | EMERGENCY ROOM PHYSICIANS | $459,911 |
| MT REHAB PT | |||||
| 702 PHILLIPS ST | CORBIN | KY | 40701 | PHYSICAL THERAPY | $364,436 |
| GE | |||||
| BOX 641419 | PITTSBURGH | PA | 64419 | BIO-MEDICAL | $343,262 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 623990 | BusinessCd |
| Total Revenue Column | $26,337,289 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,337,289 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,337,289 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $146,575 | TotalRevenueColumnAmt |
| Exclusion | $146,575 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $129,031 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $129,031 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $129,031 | TotalRevenueColumnAmt |
| Exclusion | $129,031 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PHARMACY SALES | 446110 | $798,562 | $616,454 | $182,108 | |
| MISCELLANEOUS | 900099 | $99,559 | $99,559 | ||
| MEDICAL TRANSCRIPT | 623990 | $4,653 | $4,653 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $902,774 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,515,669 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,953,743 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $182,108 | UnrelatedBusinessRevenueAmt |
| Exclusion | $379,818 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,525 | TotalAmt |
| Management And General | $374,525 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,057,283 | TotalAmt |
| Program Services | $11,508,932 | ProgramServicesAmt |
| Management And General | $548,351 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,962 | TotalAmt |
| Program Services | $122,142 | ProgramServicesAmt |
| Management And General | $5,820 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,480,523 | TotalAmt |
| Program Services | $1,413,190 | ProgramServicesAmt |
| Management And General | $67,333 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $871,455 | TotalAmt |
| Program Services | $831,822 | ProgramServicesAmt |
| Management And General | $39,633 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,160 | TotalAmt |
| Management And General | $29,160 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,325 | TotalAmt |
| Management And General | $95,325 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,255,462 | TotalAmt |
| Program Services | $1,194,629 | ProgramServicesAmt |
| Management And General | $60,833 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,998 | TotalAmt |
| Management And General | $39,998 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,612,799 | TotalAmt |
| Program Services | $5,460,057 | ProgramServicesAmt |
| Management And General | $1,152,742 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $946,047 | TotalAmt |
| Management And General | $946,047 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,199 | TotalAmt |
| Program Services | $8,137 | ProgramServicesAmt |
| Management And General | $33,062 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,996 | TotalAmt |
| Management And General | $170,996 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,209,412 | TotalAmt |
| Program Services | $1,142,894 | ProgramServicesAmt |
| Management And General | $66,518 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $2,338,499 | $2,338,499 | |
| FOOD SERVICE | $957,820 | $957,820 | |
| PROVIDER TAX | $628,987 | $628,987 | |
| MISCELLANEOUS | $460,647 | $123,840 | $336,807 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,201 | TotalAmt |
| Program Services | $23,772 | ProgramServicesAmt |
| Management And General | $221,429 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,943,300 | TotalAmt |
| Program Services | $25,125,734 | ProgramServicesAmt |
| Management And General | $4,817,566 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,938 | BOYAmt |
| EOY | $49,968 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,500,596 | BOYAmt |
| EOY | $6,624,620 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $689,684 | BOYAmt |
| EOY | $609,596 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,849 | BOYAmt |
| EOY | $344,898 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,304,458 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,391,150 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,572,489 | BOYAmt |
| EOY | $4,913,308 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,010,479 | BOYAmt |
| EOY | $3,548,149 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $817,670 | BOYAmt |
| EOY | $222,221 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,908,705 | BOYAmt |
| EOY | $16,312,760 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,985,051 | BOYAmt |
| EOY | $3,701,134 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,659,796 | BOYAmt |
| EOY | $3,341,272 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,644,847 | BOYAmt |
| EOY | $7,042,406 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,263,858 | BOYAmt |
| EOY | $9,270,354 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,263,858 | BOYAmt |
| EOY | $9,270,354 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,908,705 | BOYAmt |
| EOY | $16,312,760 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,427,631 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $434,127 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Other Cost Or Other Basis | $488,352 | OtherCostOrOtherBasisAmt |
| Book Value | $488,352 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,995,630 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,108,522 | DepreciationAmt |
| Book Value | $1,887,108 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,674,420 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,144,799 | DepreciationAmt |
| Book Value | $2,529,621 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $146,056 | OtherCostOrOtherBasisAmt |
| Depreciation | $137,829 | DepreciationAmt |
| Book Value | $8,227 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,913,308 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CASH & CD'S | $10,147 | F |
| EQUITY MUTUAL FUNDS | $3,538,002 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,548,149 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $25,177,170 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$2,338,499 | OtherRevenueAmt |
| Revenue Not Reported | -$2,338,499 | RevenueNotReportedAmt |
| Revenue Subtotal | $27,515,669 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $27,515,669 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $27,604,801 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $27,604,801 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,338,499 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,338,499 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $29,943,300 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | NO PROVISION HAS BEEN MADE FOR FEDERAL AND STATE INCOME TAXES AS THE HOSPITAL QUALIFIES AS A TAX EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL'S ACCOUNTING POLICY PROVIDES THAT A TAX EXPENSE/BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS RESULTING IN AN ACCRUAL OF TAX EXPENSE OR BENEFIT. THE HOSPITAL'S FEDERAL RETURN OF ORGANIZATION EXEMPT FOR INCOME TAX RETURN IS SUBJECT TO EXAMINATION BY THE TAXING AUTHORITIES UNTIL THE EXPIRATION OF THE REALATED STATUTE OF LIMITATIONS ON THE RETURN, WHICH IS GENERALLY THREE YEARS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 100.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $2,103,213 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $576,242 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,526,971 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,277,613 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,925,643 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,351,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11190 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,380,826 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,501,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,878,941 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16290 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,389 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,389 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,166,287 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,166,287 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10570 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,187,676 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,187,676 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10630 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,568,502 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,501,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,066,617 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.26920 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,332,944 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,621,331 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,301,604 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,680,273 | 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 |
| 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 | PINEVILLE COMMUNITY HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 RIVERVIEW AVE | AddressLine1 |
| City | PINEVILLE | City |
| State | KY | State |
| ZIP Code | 40977 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | 120 BEDS LICENSE NUMBER 100020 | WebsiteAddressTxt |
| 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 | PINEVILLE COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 100.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| 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 (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
| 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/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| PINEVILLE COMMUNITY HOSPITAL - SNF | ||||
| 850 RIVERVIEW AVE | PINEVILLE | KY | 40977 | SKILLED NURSING FACILITY |
| PINEVILLE COMMUNITY HOSPITAL - HHA | ||||
| 121 VIRGINIA AVE | PINEVILLE | KY | 40977 | HOME HEALTH AGENCY |
| PCH MEDICAL CLINIC | ||||
| 121 VIRGINIA AVE | PINEVILLE | KY | 40977 | MEDICAL CLINIC |
| PCH MEDICAL CLINIC | ||||
| 850 RIVERVIEW AVE | PINEVILLE | KY | 40977 | MEDICAL CLINIC |
| PCH MEDICAL CLINIC | ||||
| HWY 25E | FLATLICK | KY | 40972 | MEDICAL CLINIC |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | E- AMOUNT OF FUNDS THAT PINEVILLE COMMUNITY HOSPITAL EXPENDED AS COMMUNITY AWARENESS. EXAMPLES ARE LOCAL STUDENT SCHOLARSHIPS, LOCAL SCHOOL BOOSTERS ASSSOCATION, STUDENT LEADERSHIP CONFERENCE, LOCAL LITTLE LEAGUE SPORTS, PHYSICAL FITNESS, HEALTH, DIET, AGING, AND BODY SEMINAR.F- COSTS ARE ACTUAL EXPENDITURES.I- COSTS ARE ACTUAL EXPENDITURES. |
| PART III, LINE 4: | THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A DISCLOSURE FOR BAD DEBTS EXPENSE. BAD DEBTS EXPENSE IS DEDUCTED FROM PATIENT SERVICE REVENUE TO ARRIVE AT NET PATIENT SERVICE REVENUE LESS PROVISION FOR BAD DEBTS. CHARITY CARE IS NOT REPORTED AS REVENUE ON THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE NOTES TO THE FINANCIAL STATEMENTS INCLUDE THE AMOUNT OF CHARGES EXCLUDED FROM REVENUE. THE COST TO CHARGE RATIO (PERCENTAGE) UTILIZED FOR CALCULATING THE COST OF BAD DEBTS IS FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE PERCENTAGE WAS CALCULATED BY DIVIDING THE ADJUSTED PATIENT CARE COST BY THE ADJUSTED PATIENT CARE CHARGES. THE HOSPITAL'S BAD DEBT EXPENSE IS REPORTED BASED ON HFMA STATEMENT #15. |
| PART III, LINE 8: | PINEVILLE COMMUNITY HOSPITAL CONSIDERS ALL PATIENTS THE SAME AND TREATS PATIENTS IN THEIR COMMUNITY BASED ON MEDICAL NEED. MEDICARE AS A PERCENTAGE OF PATIENTS SERVED REPRESENTS THE HIGHEST PERCENTAGE. BASED ON THE NEED FOR MEDICARE SERVICES PCH WILL CONTINUE TO REACH OUT TO MEDICARE PATIENTS REGARDLESS OF THE GAIN OR LOSS ON THE SERVICE SINCE THIS IS SUCH A SIGNIFICANT PORTION OF OUR COMMUNITY. THE HOSPITAL WOULD PREFER THAT THE RETURN FROM TREATING MEDICARE PATIENTS BE A GAIN, WHICH WOULD ALLOW PCH TO DO MORE FOR THEIR COMMUNITY. |
| PART III, LINE 9B: | PATIENTS WHO HAVE PREVIOUSLY QUAILIFIED FOR CHARITY CARE PRIOR TO HAVING TREATMENT ARE PRESCREENED TO SEE IF THEY STILL MEET THE CHARITY GUIDELINES. THIS CAN BE DONE PRIOR TO A TEST BEING SCHEDULED. THE PATIENT'S INCOME LEVEL, DEPENDENT STATUS AND ASSET LEVELS ARE IDENTIFIED TO INSURE THAT THE PATIENT STILL QUAILIFIES FOR CHARITY CARE. IF THE PATIENT DOES NOT QUAILIFY FOR CHARITY CARE THEN THE HOSPITAL FOLLOWS ITS NORMAL COLLECTION POLICY JUST LIKE IT WOULD FOR ANY OTHER NON-CHARITY CARE PATIENT. |
| PART VI, LINE 2: | THE HOSPITAL DOES AN ANNUAL COMMUNITY BENEFIT REVIEW. WHILE THIS IS CONSIDERED A FULL COMMUNITY BENEFIT ASSESSMENT. THE HOSPITAL FOCUS ON ALL AREAS THAT ARE IN THE SERVICE AREA OF THE FACILITY. THIS ASSESSMENT TAKES IN TO CONSIDERATION THE POPULATION AGE, MORBIDITY, POVERTY LEVELS, EDUCATION STATUS, AND GENERAL ECONOMIC STATUS, THE PRIMARY GEOGRAPHIC AREA SERVED IS BELL CO, HARLAN CO, AND KNOX CO. THE SECONDARY MARKET AREA IS CLAY CO AND THE TWO CONTIGUOUS STATE'S THAT BORDER KENTUCKY IN THIS REGION, TENNESSEE AND VIRGINIA. THERE ARE SIGNIFICANT HEALTH EXPOSURE ISSUES FOR RESIDENTS IN THIS AREA BASED ON OCCUPATIONS CATEGORIES AS FOLLOWS:COAL MINING- BLACK LUNG DISEASE IN EARLY STAGES AND COPD IN OLDER POPULATIONTIMER INDUSTRY- LOGGING LEADS TO HEAVY INJURY AND DISABILITIY GROUP IN THE POPULATION.THE GENERAL POPULATION AS A GROUP HAS A VERY HIGH HEALTH RISK EXPOSURE FROM THE PREVALENCE OF SMOKING IN THE GENERAL POPULATION AND THE OBESITY RATE OF THE POPULATION IS SIGNIFICANTLY HIGH; PLUS,THE GENERAL INCREASE IN OVERALL POPULATION FROM AGING IS A FACTOR. |
| PART VI, LINE 3: | THE HOSPITAL INFORMS THE GENERAL POPULATION CONCERNING THE CHARITY CARE POLICY THROUGH THE GENERAL ADMISSION SCREENING PROCESS AND A SUMMARY OF THE CHARITY CARE FUNCTION IS IN ALL AREA'S OF THE HOSPITAL THAT HAVE PATIENT CARE REGISTRATION FUNCTION OR CONTACT. HOSPITAL EMPLOYEES ARE EDUCATED TO MAKE PATIENTS AWARE OF THE HOSPITAL'S CHARITY CARE POLICY AND HOW IT APPLIES TO EACH PATIENT AND WHERE PATIENTS CAN GO FOR ADDITIONAL INFORMATION OR EDUCATION ON THE HOSPITAL'S CHARITY CARE POLICY. ALL PHYSICIAN OFFICES IN THE GENERAL AREA OF THE HOSPITAL ARE FULLY AWARE OF THE HOSPITAL'S CHARITY CARE POLICY AND DIRECT PATIENTS TO THE HOSPITAL. |
| PART VI, LINE 4: | PINEVILLE HOSPITAL'S PRIMARY MARKET AREA IS IN THE HEART OF EASTERN APPALACHIA COMPRISED OF BELL CO., HARLAN CO. AND KNOX CO. THE HOSPITAL'S SECONDARY MARKET AREA IS COMPRISED OF CLAY CO. AND THE TWO CONTINUOUS STATE'S THAT BORDER KENTUCKY, TENNESSEE AND VIRGINIA. |
| PART VI, LINE 5: | PINEVILLE COMMUNITY HOSPITAL IS QUITE INVOLVED IN THE COMMUNITY THAT IT SERVES. THE HOSPITAL HAS AN OPEN MEDICAL STAFF THAT IS OPEN TO ALL QUALIFIED PHYSICIANS. THE MEDICAL STAFF OF THE HOSPITAL DOES NOT SOLELY LIVE IN ONE COMMUNITY BUT RESIDES IN OUTLAYING COMMUNITIES AS WELL. THE HOSPITAL'S MANAGING BOARD ARE ALL RESIDENTS OF THE HOSPITAL'S PRIMARY MARKET AREA. THEY LIVE, WORK, AND WORSHIP WITH THE COMMUNITY THAT THE HOSPITAL SERVICES. AS SUCH, THEY SEE AND HEAR THE NEEDS OF THE HOSPITAL'S MARKET AREA. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J MILTON BROOKS | ||||||||||||||
| CEO/DIRECTOR | $246,054 | $0 | $0 | $0 | $0 | $0 | $4,986 | $0 | $12,942 | $0 | $263,982 | $0 | $0 | $0 |
| UYI-OGHOSA IDEMUDIA | ||||||||||||||
| DOCTOR | $219,759 | $0 | $0 | $0 | $0 | $0 | $4,448 | $0 | $4,541 | $0 | $228,748 | $0 | $0 | $0 |
| LINDA SCEARSE | ||||||||||||||
| CRNA | $174,532 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,541 | $0 | $179,073 | $0 | $0 | $0 |
| WILLIAM GAUNT | ||||||||||||||
| DOCTOR | $244,355 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,541 | $0 | $248,896 | $0 | $0 | $0 |
| MICHAEL PETERSON | ||||||||||||||
| DOCTOR | $168,566 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,942 | $0 | $181,508 | $0 | $0 | $0 |
| RHONDA KECK | ||||||||||||||
| CRNA | $173,601 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,942 | $0 | $186,543 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | MR. BROOKS PARTICIPATES IN A NONQUALIFIED RETIREMENT PLAN PAID FOR BY THE HOSPITAL. FOR FYE JUNE 30, 2014 THE HOSPITAL CONTRIBUTED $25,000 TO THE PLAN. |
| PART I, LINE 6 | TO BETTER SERVE THE NEEDS OF THE TRI-COUNTY AREA, IN 2008, THE HOSPITAL BEGAN HIRING PHYSICIAN EMPLOYEES. IN FULFILLMENT OF THE TERMS OF THEIR EMPLOYMENT CONTRACTS, DOCTORS CAN RECEIVE INCENTIVE PAY CALCULATED AS A PERCENTAGE OF THE NET PROFITS OF THE MEDICAL PRACTICE SERVICES THEY PROVIDE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORMS 990 AND 990-T ARE REVIWED BY THE OFFICERS OF THE COMPANY FOR COMPLETENESS AND ACCURACY. PRIOR TO FILING THE FORMS 990 AND 990-T THEY ARE PRESENTED TO THE BOARD FOR REVIEW AND DISCUSSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | AT A BOARD MEETING JUST AFTER THE START OF EACH FISCAL YEAR, THE CHAIRMAN OF THE BOARD MAKES EACH BOARD MEMBER AWARE OF THEIR RESPONSIBILIES AS IT REALTES TO THE COMPLETION OF THE CONFLICT OF INTEREST STATEMENT. EACH BOARD MEMBER IS GIVEN A PACKET CONTAINING THE CONFLICT OF INTEREST STATEMENT TO BE COMPLETED, SIGNED AND RETURNED AT THE NEXT BOARD MEETING. THE CHAIRMAN OF THE BOARD IS RESPONSIBLE FOR ENSURING THAT ALL OF THE CONFLICT OF INTEREST STATEMENTS ARE COMPLETED, SIGNED AND RETURNED FOR EACH FISCAL YEAR. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO ON AN ANNUAL BASIS IS REVIEWED BY THE ENTIRE BOARD OF DIRECTORS. THIS IS A WRITTEN EVALUATION. ALL BOARD MEMBERS DO AN EVALUATION ON THE CEO. THEY THEN COMPILE ALL COMMENTS INTO ONE PACKAGE PRIOR TO MEETING WITH THE CEO TO DISCUSS THE EVALUATION. GOALS ARE ESTABLISHED FROM THIS EVALUATION PROCESS FOR THE NEXT FISCAL YEAR. COMPENSATION IS SET EACH YEAR AND THERE ARE NO OTHER COMPENSATION BESIDES SALARY, I.E. BONUS. THE BOARD HAS AVAILABLE THE FOLLOWING OUTSIDE RESOURCE ENTITIES THAT CAN BE UTILIZED TO DETERMINE IF THE COMPENSATION PACKAGE IS ADEQUATE/INADEQUATE. PRIMARILY INCREASES OR LIMITED TO INCREASES DUE TO COST OF LIVING. SOME OF THE AGENCIES THAT MAYBE/HAVE BEEN USED ARE: KENTUCKY HOSPITAL ASSOCIATION (KHA) HOSPITAL BASED SALARY BY POSITION BY HOSPITAL SIZE; QUORUM HEALTHCARE MANAGEMENT HOSPITAL BASE SALARY GUIDELINES; SESCO MANAGEMENT CONSULTANTS- BRISTOL, TN |
| FORM 990, PART VI, SECTION C, LINE 18 | THE 990 AND 990-T ARE AVAILABLE THROUGH WWW.GUIDESTAR.ORG AND BY REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTERTEST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE HOSPITAL DOES PUBLISH THEIR YEARLY FINANCIAL OUTCOMES IN THE HOSPITAL NEWSLETTER WHICH IS MAILED TO MOST OF THE MARKET AREA SERVED BY THE HOSPITAL. PLUS, COPIES ARE DISTRIBUTED TO PATIENTS, FAMILIES AND VISITORS TO THE HOSPITAL. ALSO, FINANCIAL STATEMENTS ARE POSTED WITH THE CREDIT AGENCY DUNN & BRADSTREET FOR COMMERCIAL USERS. |
| FORM 990, PART VII | JOHN G. HOWARD - 155 ANDREW COURT, HARROGATE, TN 37752. JAY STEELE - 106 CHERRY ST, PINEVILLE, KY 40977. JOHN JONES - 145 HORSESHOE DR, PINEVILLE, KY 40977. CHARLES BISHOP - 133 WOODLAND TR, PINEVILLE, KY 40977. MANSFIELD DIXON, DMD - 121 VIRGINIA AVE, PINEVILLE, KY 40977. DAVID GRAMBREL - 113 RIDGEWOOD CIRCLE, PINEVILLE, KY 40977. JERRY WOOLUM, MD - 121 VIRGINIA AVENUE, PINEVILLE, KY 40977. TALMADGE HAYS, MD - 121 VIRGINIA AVENUE, PINEVILLE, KY 40977. EMANUEL RADER, MD - P.O. BOX 70, PINEVILLE, KY 40977. JOHN COMBS - PO BOX 573, PINEVILLE, KY 40977. ALBEN BROCK - PO BOX 339, PINEVILLE, KY 40977. |
| FORM 990, PART XI, 2C, SELECTION AND OVERSIGHT OF INDEPENDENT ACCOUNTANT: | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION AND OVERSIGHT OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| SCH H, PART V, NUMBER AND TYPES OF OTHER HEALTH CARE FACILITIES: | 3 MEDICAL CLINICS |