2014-08-13T16:29:07-05:00 2013-09-30 BKD LLP 400 E MAIN ST STE 200 PO BOX 1196 BOWLING GREEN KY 421021196 990 2012-10-01 620988604 MACON HOSPITAL INC % THOMAS J KIDD CPA MACO 6156662147 204 MEDICAL DRIVE Suite LAFAYETTE TN 37083 THOMAS J KIDD CPA 6156662147 2014-08-13 true JESSICA FREEMAN 2707810111 2012 2015-11-30 17:44:51Z DENNIS WOLFORD 204 MEDICAL DRIVE LAFAYETTE TN 37083 12151403 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 8 182 8 0 27456 20891 11428283 11628973 35967 15859 652756 485680 12144462 12151403 0 0 0 0 6144909 6225261 0 0 0 6063989 6142540 12208898 12367801 -64436 -216398 5265951 4794946 1216077 961470 4049874 3833476 THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. false false 10554152 11638713 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 6,681 INDIVIDUALS. PROVIDED $233,000 OF CHARITY CARE FOR YEAR ENDED SEPTEMBER 30, 2013. 10554152 true false 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 34 0 true 182 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 2.0 X X 1000 0 0 LINDA AUSTIN 1.0 X 1000 0 0 FEMI ODUNUSI MD 1.0 X 900 0 0 HL GOODALL 1.0 X 1100 0 0 HUGH CLARK 1.0 X 1100 0 0 FRED SCRUGGS 1.0 X 600 0 0 RADFORD WEST 2.0 X X 1100 0 0 STANLEY CHUNN MD 3.0 X X 1000 0 0 THOMAS KIDD 50.0 X 0 0 0 DENNIS WOLFORD 50.0 X 0 0 0 7800 0 0 0 false false true EM CARE PHYSICIAN SVC 7032 COLLECTION CENTER DR CHICAGO IL 60693 PHYSICIAN STAFFING 417228 ALLIANCE IMAGING INC PO BOX 96485 CHICAGO IL 60693 MRI 256922 PAINTER HUDSON PHARMACIST 1515 OLD LAKE ROAD RED BOILING SPRINGS TN 37150 PHARMACY COVERAGE 130233 NUCLEAR IMAGING MGMT CORP 1035 HUNTERS HORN GALLATIN TN 37066 IMAGING SERVICES 126210 QHR 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT SERVICES 523300 5 20891 20891 NET PATIENT SERVICE REVENUE 621110 11575344 11575344 OTHER OPERATING 621110 53629 53629 11628973 15859 15859 0 0 38900 38900 0 38900 38900 0 0 0 0 EHR INCENTIVES 900099 430000 430000 RESPITE CARE 624100 6000 6000 MASSAGE/WELLNESS 900099 3740 3740 7040 7040 446780 12151403 11638713 491799 0 0 0 0 7800 7800 0 5019548 4257604 761944 76109 64456 11653 760605 644148 116457 361199 305895 55304 194134 194134 0 74140 74140 0 0 0 1600475 1271742 328733 16077 16077 1172896 1060866 112030 0 0 161607 161607 45453 31103 14350 0 0 0 0 468154 468154 200364 200364 BAD DEBTS 1564488 1564488 REPAIRS & MAINTENANCE 257707 225993 31714 DUES & SUBSCRIPTIONS 47186 19165 28021 MEDICAL SUPPLIES 274285 274271 14 65574 4296 61278 12367801 10554152 1813649 0 929980 507437 1111048 1125207 0 0 1225433 1181398 0 0 0 0 0 0 184573 178533 137705 124137 6971213 5292979 1677212 1678234 0 0 0 0 0 0 0 0 0 0 5265951 4794946 695840 936713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520237 24757 1216077 961470 X 4049874 3833476 0 0 0 0 4049874 3833476 5265951 4794946 -216398 X false true X true false X false false false false false false false false true 923 923 false LOBBYING EXPENDITURES 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 2185481 2023249 162232 40170 39733 437 4121686 3150340 971346 138389 79657 58732 1678234 0 DUE TO THIRD PARTY PAYERS 24757 24757 10586915 -1564488 -1564488 12151403 12151403 10803313 10803313 1564488 1564488 12367801 INCOME TAXES SCH D, PART X, LINE 2 ------------------------------------ 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. RECONCILIATION TO AUDIT REPORT SCH D, PART XI & XII ------------------------------ PART XI LINE 2D OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON 990 PART VIII: ------------------------------ BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT ($1,564,488) PART XII LINE 2D OTHER ITEMS INCLUDED ON 990 PART IX BUT NOT ON LINE 1: ------------------------------ BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT $1,564,488 true true true X true X 100 false true true false false 232824 232824 0.02160 2351089 2351089 0.21760 2583913 2583913 0.23920 2583913 2583913 0.23920 true 1564488 657085 5166873 4785636 381237 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 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 BAD DEBTS SCH H, PART III, LINE 4 ------------------------------------ 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. COSTING METHODOLOGY SCH H, PART III, LINE 8 ------------------------------------ THE MEDICARE COST REPORT WAS USED TO DETERMINE LINE 6. NEEDS ASSESSMENT SCH H, PART VI, LINE 2 ------------------------------------ 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 20TH YEAR. MCGH STAFF WORKS WITH THE MACON COUNTY SCHOOL SYSTEM COORDINATED 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCH H, PART VI, LINE 3 ------------------------------------ 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. COMMUNITY INFORMATION SCH H, PART VI, LINE 4 ------------------------------------ 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). PROMOTION OF COMMUNITY HEALTH SCH H, PART VI, LINE 5 ------------------------------------ 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 TEH 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. COMMUNITY INPUT SCH. H, PART V, SECTION B, LINE 3 ------------------------------------ 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. IMPLEMENTATION STRATEGY SCH. H, PART V, SECTION B, LINE 6 ------------------------------------ MACON COUNTY'S IMPLEMENTATION STRATEGY IS ATTACHED TO FORM 990. HEALTH NEEDS ADDRESSED SCH. H, PART V, SECTION B, LINE 7 --------------------------------- THE TOP 5 HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT ARE ADDRESSED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN. X X false false false false false false false false false THOMAS KIDD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DENNIS WOLFORD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMPENSATION FROM UNRELATED ORGANIZATION SCH J, PART II ------------------------------------ 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 $329,300 for services provided by these individuals for the fiscal year ending September 30, 2013. DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSON FORM 990, PART VI, QUESTION 3 ------------------------------------ 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, 2013, Macon County Hospital paid QHR $142,183 for the services of Thomas Kidd (CFO) and $187,117 for the services of Dennis Wolford (CEO). PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THE CEO AND CFO. PROCESS TO REVIEW THE FORM 990 FORM 990, PART VI, QUESTION 11B ------------------------------------ A COPY OF THE FORM 990 WILL BE PROVIDED TO THE FULL BOARD AT A BOARD MEETING PRIOR TO FILING. PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 12C ------------------------------------ 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. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, QUESTIONs 15A & 15B ------------------------------------ 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. MAKING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 ------------------------------------ THE ORGANIZATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE STORED IN ADMINISTRATION AND AVAILABLE UPON REQUEST.