2013-05-29T16:40:38-05:00 2012-09-30 KERBER ECK & BRAECKEL LLP 1116 W MAIN ST CARBONDALE IL 629012335 990 2011-10-01 610445841 MUHLENBERG COMMUNITY HOSPITAL INC MUHL 2703388000 440 HOPKINSVILLE ST GREENVILLE KY 423451124 JOSEPH SWAB 2703388000 2013-05-29 MARK DALLAS 6185291040 2013-05-29 2011 2016-03-07 17:11:31Z JOHN COUNTZLER 440 HOPKINSVILLE ST GREENVILLE KY 42345 34083991 false X WWW.MCHKY.ORG X 1938 KY PATIENT CARE - HEALTHCARE SERVICES 9 7 591 32 0 894460 462399 32659530 32843901 111548 422338 123873 190573 33789411 33919211 0 0 19447212 20148971 0 0 14251991 15332177 33699203 35481148 90208 -1561937 21219725 20734954 2630740 3835595 18588985 16899359 PATIENT CARE - HEALTHCARE SERVICES false false 35481148 32832445 HEALTH CARE DELIVERY & MANAGEMENT: THE HOSPITAL OPERATES A 90 BED ACUTE CARE AND A 45 BED SKILLED NURSING FACILITY WITH RELATED OUTPATIENT AND ANCILLARY SERVICES, INCLUDING A 24 HOUR EMERGENCY DEPARTMENT. MUHLENBERG COMMUNITY HOSPITAL (MCH) PARTICIPATES WITH MEDICARE, MEDICAID AND INDIGENT CARE PROGRAMS IN THE STATE OF KENTUCKY. THE HOSPITAL PROMOTES AND FURTHERS THE HEALTH AND GENERAL STANDARDS OF LIVING IN OUR COMMUNITY. THE ACTIVITY OF RENDERING HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, ACCOMPLISHES THE HOSPITAL'S EXEMPT PURPOSE. 35481148 true true false false false false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false true false true false false false false true true false false false false true 44 0 591 true false false false false false false false false false false false false X 9 7 true true false false false false false true true false false true true true true true true true true true false X JOE SWAB 2703388277 440 HOPKINSVILLE ST GREENVILLE KY 42345 DR VINCENT P GENOVESE 40.00 X 392173 0 0 CHARLES R LEWIS 2.00 X 0 0 0 DAVID JERNIGAN 2.00 X 0 0 0 W LEE FAUNTLEROY 2.00 X 0 0 0 TAMMY S BREWER 2.00 X 0 0 0 DR MARY WEBB BROWN 2.00 X 0 0 0 LANIE WEBB GARDNER 2.00 X 0 0 0 DR WILLARD KEITH 2.00 X 0 0 0 DR FREDDIE MAYES 2.00 X 0 0 0 JOHN COUNTZLER 40.00 X 117322 0 0 KATHLEEN MITCHELL 40.00 X 107741 0 0 JOSEPH SWAB 40.00 X 36343 0 0 DR DENNIS KNOEPFLER 40.00 X 346963 0 0 LAURA STILES 40.00 X 108556 0 0 ANN C MURPHY 40.00 X 108013 0 0 1217111 6 false true true ALLIANT MANAGEMENT SERVICES 2650 EASTPOINT PKWY SUITE 310 LOUISVILLE KY 40223 MANAGEMENT SERV 444222 KY EMERGENCY ROOM PHYSICIAN 320 DAWN DRIVE GREENVILLE KY 42345 ER PHYS/HOSPITA 401690 SODEXHO 9801 WASHINGTON BLVD GAITHERSBERG MD 20878 DIETERYSRVCMGMT 149651 GWC SYSTEMS 1232 STATE ROUTE 973 GREENVILLE KY 42345 IT CONSULTING 130946 QUEST DIAGNOSTICS PO BOX 101071 ATLANTA GA 30374 LABORATORY SERV 114975 7 357600 104799 462399 NET PATIENT SERVICE REVENUE 32843901 32843901 32843901 433794 433794 29739 29739 29739 29739 153324 164780 -11456 -11456 -11456 DIETARY / CAFETERIA 128217 128217 MISCELLANEOUS 32617 32617 160834 33919211 32832445 624367 261406 261406 15287160 15287160 1905 1905 3419820 3419820 1178680 1178680 567530 567530 115062 115062 56376 56376 3126129 3126129 182520 182520 683579 683579 123553 123553 1898968 1898968 125304 125304 80927 80927 47864 47864 1423368 1423368 539652 539652 MEDICAL SUPPLIES & DRUGS 5318458 5318458 PROVIDER & OTHER TAXES 871627 871627 MEMBERSHIPS & SUBSCRIPTIO 111786 111786 MISCELLANEOUS 59474 59474 35481148 35481148 0 0 1825 717399 430037 6486848 6840313 1186162 1179243 355788 558592 39868565 31527001 7966580 8341564 4515213 1187132 707309 1122721 357953 21219725 20734954 2578740 2749204 874244 52000 212147 2630740 3835595 X 18588985 16899359 18588985 16899359 21219725 20734954 X -1561937 -127689 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 208485 208485 11549755 8653036 2896719 27103693 22451879 4651814 1006632 422086 584546 8341564 304728 C BOARD DESIGNATED FUNDS 882404 F 1187132 DUE TO THIRD-PARTY PAYORS 160147 MCH FOUNDATION - NOTE PAYABLE 52000 212147 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X MUHLENBERG COMMUNITY HOSPITAL IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. MANAGEMENT IS NOT AWARE OF ANY ACTIVITY WITHIN THE HOSPITAL DURING THE CURRENT OR PRIOR REPORTING PERIODS THAT WOULD JEOPARDIZE OR OTHERWISE CALL INTO QUESTION THE HOSPITAL'S COMPLIANCE WITH THE ABOVE INTERNAL REVENUE CODE SECTION. true true true X false true true true false true true 1850579 268075 1582504 0.04460 7171260 4660568 2510692 0.07080 9021839 4928643 4093196 0.11540 104495 104495 0.00290 104495 104495 0.00290 9126334 4928643 4197691 0.11830 true 1654648 827324 13599051 14910669 -1311618 X true true 1 1 MUHLENBERG COMMUNITY HOSPITAL INC

440 HOPKINSVILLE ST GREENVILLE KY 423450387

X X X HOME HEALTH-EMS-SKILLED NURSIN MUHLENBERG COMMUNITY HOSPITAL INC 1 true true 200.0 false true X true true X true X X true X X X X X true X false false COMMUNITY BUILDING ACTIVITIES PART II MUHLENBERG COMMUNITY HOSPITAL HAS AN ONGOING COMMITMENT TO ITS COMMUNITY DUE TO MUHLENBERG COUNTYS HIGH RATE OF JOBLESSNESS THE HOSPITAL DECIDED IT WAS IN THE COMMUNITYS BEST INTEREST TO SUPPORT LOCAL VENDORS WHEN POSSIBLE AND TO SUPPORT COMMUNITY EFFORTS TO BRING NEW INDUSTRY TO THE REGION THE HOSPITAL ALSO SUPPORTS LOCAL DISASTER PREPAREDNESS ACTIVITIES BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE TOTAL BAD DEBT EXPENSE AT COST REPRESENTS THE TOTAL AMOUNT EXPECTED TO BE COLLECTED BUT DEEMED UNCOLLECTIBLE BASED ON THE COMMUNITYS DEMOGRAPHICS INCOME LEVEL INDIVIDUAL ASSETS AND HEALTH COVERAGE 50 WAS DETERMINED TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITALS PATIENT FINANCIAL ASSISTANCE PROGRAM PATIENTS ARE SCREENED FOR DSH AND CHARITY BASED ON APPLICATIONS THE ONES WHO DO NOT QUALIFY BECOME BAD DEBT ACCOUNTS FINANCIAL STATEMENT FOOTNOTE PATIENT ACCOUNTS RECEIVABLE ARE ORDINARILY DUE THIRTY DAYS AFTER THE ISSUANCE OF THE INVOICE AT THE EXPIRATION OF THE THIRTY DAYS IF NO RESPONSE IS RECEIVED FROM THE PATIENT A STATEMENT IS GENERATED AND FORWARDED TO AN OUTSOURCE AGENCY HEALTH CLAIMS MANAGEMENT HCM HCM WILL GENERATE AND PROCESS A TOTAL OF THREE STATEMENTS TO COLLECT THE AMOUNT DUE ADDITIONAL STATEMENTS COULD BE GENERATED IF A PAYMENT ARRANGEMENT HAS BEN APPROVED IF THE HOSPITAL RECEIVES NO PAYMENT OR COMMUNICATION TO ARRANGE PAYMENT THE ACCOUNT IS SENT TO COLLECTION AND RECOGNIZED AS BAD DEBT AT THAT TIME MEDICARE EXPLANATION PART III LINE 8 THE TOTAL MEDICARE ALLOWABLE COSTS OF CARE REPRESENTS THE AMOUNT REPORTED IN THE HOSPITALS MEDICARE COST REPORT MUHLENBERG COMMUNITY HOSPITALS MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT DUE TO THE COMMUNITY IT SERVES MEDICARE REPRESENTS 42 OF THE HOSPITALS PAYOR MIX WITH MEDICARE REPRESENTING SUCH A LARGE PORTION OF THE PAYOR MIX THE HOSPITAL DEPENDS ON MEDICARE PAYMENTS IF MEDICARE PAYS LESS THAN COST IT IS DETRIMENTAL TO THE HOSPITAL AND THEREFORE SHOULD BE CONSIDERED AS COMMUNITY BENEFIT COLLECTION PRACTICES EXPLANATION PART III LINE 9B PATIENT ACCOUNTS THAT ARE APPROVED FOR CHARITY ARE WRITTEN OFF TO OUR HOSPITAL CHARITY ADJUSTMENT THE PATIENT IS NOTIFIED OF CHARITY APPROVAL BY MAIL NO FURTHER STATEMENTS OF ACCOUNT OR OTHER CORRESPONDENCE ARE ISSUED NEEDS ASSESSMENT PART VI MUHLENBERG COMMUNITY HOSPITAL ASSESSES THE COMMUNITYS HEALTH CARE NEEDS BY OBTAINING INFORMATION FROM A VARIETY OF SOURCES INCLUDING A DEMOGRAPHIC DATABASES B LOCAL AND REGIONAL HEALTH DEPARTMENTS AND RELATED DATABASES C KENTUCKY HOSPITAL ASSOCIATION REPORTS AND DATABASES D MARKET ANALYSIS E FEEDBACK FROM PHYSICIANS AND OTHER INTERESTED COMMUNITY GROUPS F HOSPITALGENERATED REPORTS ON UTILIZATION OF SERVICES G BOARD OF DIRECTORS MADE UP OF LOCAL COUNTY RESIDENTS PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI MUHLENBERG COMMUNITY HOSPITAL REACHES OUT TO EDUCATE PATIENTS ABOUT THE PATIENT FINANCIAL ASSISTANCE PROGRAM THE PATIENT FINANCIAL ASSISTANCE PROGRAM INFORMATION IS INCLUDED IN THE PATIENT INFORMATION HANDBOOK THAT IS GIVEN TO EVERY PATIENT AT THE TIME OF REGISTRATION THE ADMISSION CONSENT FORM ALSO INCLUDES AN ACKNOWLEDGEMENT BY THE PATIENT THAT THEY WERE GIVEN THE HANDBOOK IN ADDITION SELFPAY PATIENTS ARE INFORMED OF FEDERAL STATE AND LOCAL GOVERNMENTAL ASSISTANCE PROGRAMS WITHIN 24 HOURS OF ADMISSION SELFPAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR AND INFORMED OF THE AVAILABLE PROGRAMS COMMUNITY INFORMATION PART VI THE PRIMARY SERVICE AREA FOR MUHLENBERG COMMUNITY HOSPITAL IS MUHLENBERG COUNTY KENTUCKY POPULATION OF 31272 IN 2011 LOCATED 115 MILES NORTH OF NASHVILLE TN 125 MILES WOUTHWEST OF LOUISVILLE KY AND 70 MILES SOUTH OF EVANSVILLE IN THE HOSPITALS SECONDARY SERVICE AREA INCLUDES PARTS OF HOPKINS TODD OHIO MCLEAN BUTLER LOGAN AND CHRISTIAN COUNTIES WHICH ARE THE SURROUNDING COUNTIES THE ESTIMATED PERCENTAGE OF PEOPLE LIVING BELOW THE POVERTY LEVEL AS DETERMINED BY THE US CENSUS BUREAU 20072011 IS 205 FOR MUHLENBERG COUNTY AND AN AVERAGE OF 198 OF THE SECONDARY SERVICE AREA THE AREA IS MOSTLY RURAL WITH A HIGHER PERCENTAGE OF PERSONS OVER THE AGE OF 65 AND A SIGNIFICANTLY LOWER MEDIAN HOUSEHOLD INCOME THAN FORALL OF KENTUCKY THE AVERAGE UNEMPLOYMENT RATE IN MUHLENBERG COUNTY FOR THE THE CALENDAR YEAR 2011 WAS 98 COMPARED TO THE STATE AVERAGE OF 95 HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI HEALTH AND COMMUNITY IN RELATION TO EXEMPT PURPOSE MUHLENBERG COMMUNITY HOSPITAL AND ITS EMPLOYEES HAVE A RICH HISTORY OF PLANNING ANDOR SPONSORING EVENTS DESIGNED TO EDUCATE THE COMMUNITY ON HEALTHY LIVINGAND WELLNESS FACTORS EVENTS DURING THE FISCAL YEAR ENDING 9302012 INCLUDED HEALTH FAIRS AND SCREENINGS FOR THE COMMUNITY AND PRIVATE ORGANIZATIONS MUHLENBERG COMMUNITY HOSPITAL ADHERES TO THE FOLLOWING IRS EXEMPTION REQUIREMENTS A ACCEPT AND TREAT MEDICARE AND MEDICAID PATIENTS B EMERGENCY DEPARTMENT OPEN TO ALL EMERGENT CASES REGARDLESS OF ABILITY TO PAY C OPEN MEDICAL STAFF THAT ALLOWS CREDENTIALED PHYSICIANS TO PRACTICE AT THE FACILITY D OPERATE UNDER COMMUNITY BOARDS CONTROL IT IS THE MISSION AND ONGOING GOAL OF THE LEADERSHIP AND EMPLOYEES OF MUHLENBERG COMMUNITY HOSPITAL TO DO THE BEST JOB POSSIBLE TREATING THE SICK AND INJURED ADDRESSING COMMUNITY WELLNESS NEEDS AND PROMOTING HEALTHY LIVING AT EVERY OPPORTUNITY THROUGH OUR MANY COMMUNITY BENEFIT ACTIVITIES OUR CHARITY CARE PROGRAM AND OUR ACCEPTANCE OF PATIENTS COVERED BY FEDERAL AND STATE PROGRAMS MUHLENBERG COMMUNITY HOSPITAL MAKES A POSITIVE DIFFERENCE IN THE QUALITY OF LIFE IN THE COMMUNITY WE SERVE MUHLENBERG COMMUNITY HOSPITAL INC LINE NUMBER 1 PART V LINE 13G PART V LINE 13G THE HOSPITAL SCREENS ALL PATIENTS FOR MEDICAID DSH AND CHARITY MUHLENBERG COMMUNITY HOSPITAL INC LINE NUMBER 1 PART V LINE 19D PART V LINE 19D THIS HOSPITAL FOLLOWS THE ESTABLISHED POLICY FOR FINANCIAL ASSISTANCE X X false false false false false false false false false DR VINCENT P GENOVESE 392173 392173 JOHN COUNTZLER 117322 117322 JOSEPH SWAB 36343 36343 DR DENNIS KNOEPFLER 346963 346963 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III MUHLENBERG COMMUNITY HOSPITAL HIRED ALLIANT MANAGEMENT SERVICES (ALLIANT) TO PROVIDE MANAGEMENT SERVICES FOR THE HOSPITAL. ALLIANT IS RESPONSIBLE FOR PROVIDING THE HOSPITAL WITH A CEO AND CFO AS WELL AS PAYING THEIR ANNUAL SALARIES. KENTUCKY EMERGENCY ROOM PHYSICIANS DR. KEITH-OWNER 401690 ER PHYSICIAN SERVICE false ADDITIONAL INFORMATION SCHEDULE L PART V REGARDING TRANSACTIONS DISCLOSED IN PART IV ABOVE THE TRANSACTIONS WITH KENTUCKY EMERGENCY ROOM PHYSICIANS KERP ARE FOR EMERGENCY DEPARTMENT AND HOSPITALIST COVERAGE THESE PAYMENTS REPRESENT TRANSACTIONS BASED ON FAIR MARKET VALUE OF SERVICES PROVIDED THE KERP TRANSACTIONS ARE REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERS PROVIDE NON-CLINICAL SERVICES, INCLUDING OFFICE ASSISTANCE, STAFFING THE INFORMATION DESK, AND OPERATING THE GIFT SHOP. RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 DR MARY K BROWN LANIE WEBB GARDNER BOARD MEMBER BOARD MEMBER FAMILY RELATIONSHIP CHARLES R LEWIS DR WILLARD KEITH BRD.CHAIRMAN BOARD MEMBER BUSINESS RELATIONSHIP MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL IS EMPLOYED BY ALLIANT MANAGEMENT SERVICES AND IS RESPONSIBLE FOR CONTROLLING MANAGEMENT DUTIES. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE CEO REVIEWS THE 990 WITH THE BOARD OF DIRECTORS BEFORE IT IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ALL MANAGEMENT EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO UPDATE AND SIGN OFF ON A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A ALLIANT MANAGEMENT SERVICES EMPLOYS THE HOSPITAL'S CEO AND CFO. THEY PERFORM COMPARABILITY STUDIES AND RECOMMEND SALARY PACKAGES TO THE HOSPITAL'S PERSONNEL COMMITTEE. THE SALARY PACKAGES ARE REVIEWED AND APPROVED BY THE HOSPITAL'S PERSONNEL COMMITTEE. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPARABILITY DATA IS REVIEWED REGARDING THE CEO AND CFO'S SALARY PACKAGES. THE SALARY PACKAGES ARE REVIEWED AND APPROVED BY THE HOSPITAL'S FINANCE COMMITTEE ON AN ANNUAL BASIS. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS INCLUDES A 6 VARIANCE DUE TO ROUNDING AND A DECREASE OF 127,695 RELATED TO THE CHANGE IN NET UNREALIZED LOSSES ON INVESTMENTS, OTHER THAN TRADING SECURITIES. MUHLENBERG SURGERY CENTER LLC 1008 MEDICAL CENTER DRIVE POWDERLY KY 42367 611398071 SURGERY KY 743447 1112488 MCH COMMUNITY HOSPITAL THE MUHLENBERG COMMUNITY HOSPITAL F OUNDATION 440 HOPKINSVILLE ST GREENVILLE KY 423450387 261600611 FUNDRAISIN KY 501C3 9 MCH false MUHLENBERG MEDICAL PROPERTIES IV LL 1010 MEDICAL CENTER DRIVE POWDERLY KY 42367 010571762 LESSOR KY N/A RELATED 40000 304728 false true 0.49000 GENESIS HEALTH ALLIANCE LLC 3700 WASHINGTON AVENUE EVANSVILLE IN 47714 208223181 PURCHASING IN N/A RELATED 1166 9197 false true 0.04350 false false false false false false false false false false false false false false false true false false