CRITTENDEN COUNTY HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CRITTENDEN COUNTY HOSPITAL INC (EIN 61-0391376)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-06-28
- IRS object ID
- 201211809349300041
- Schema version
- 2010v3.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-06-28T14:47:33-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 E MAIN ST STE 200 PO BOX 1196 | AddressLine1 |
| City | BOWLING GREEN | City |
| State | KY | State |
| ZIP Code | 421021196 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610391376 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENDEN COUNTY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CRIT | NameControl |
| Phone | 2709651042 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 386 | AddressLine1 |
| City | MARION | City |
| State | KY | State |
| ZIP Code | 42064 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARL J CHRISTENSEN | Name |
| Title | CEO | Title |
| Date Signed | 2012-06-28 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KIM SCIFRES | Name |
| Phone | 2707810111 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENDEN HEALTH SYSTEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CARL J CHRISTENSEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 W Gum Street | AddressLine1 |
| City | MARION | City |
| State | KY | State |
| ZIP Code | 42064 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14734052 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CRITTENDEN-HEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1942 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF CRITTENDEN HEALTH SYSTEMS IS TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE HEALTH CARE TO THE RESIDENTS OF CRITTENDEN COUNTY AND SURROUNDING COUNTIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 275 | TotalNbrEmployees |
| Total Nbr Volunteers | 48 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 10716 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 23285 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 13630304 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13556906 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 88717 | InvestmentIncomePriorYear |
| Investment Income Current Year | 56033 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 933862 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1097828 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14663599 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14734052 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9587736 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9955990 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5385027 | OtherExpensePriorYear |
| Other Expenses Current Year | 5334523 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14972763 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15290513 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -309164 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -556461 | RevenuesLessExpensesCY |
| Total Assets BOY | 9909533 | TotalAssetsBOY |
| Total Assets EOY | 10756416 | TotalAssetsEOY |
| Total Liabilities BOY | 2373926 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3777270 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7535607 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6979146 | NetAssetsOrFundBalancesEOY |
| Mission Description | The mission of Crittenden Health Systems is to provide high-quality, cost-effective health care to the residents of Crittenden County and surrounding counties. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 12976631 | Expense |
| Grants | 0 | Grants |
| Revenue | 14110553 | Revenue |
| Description | PROVIDED ACUTE, OUTPATIENT, EMERGENCY, AMBULANCE AND OTHER HEALTH SERVICES TO THE RESIDENTS OF CRITTENDEN COUNTY AND SURROUNDING COUNTIES, INCLUDING $1,277,000 OF CHARITY CARE | Description |
| Total Program Service Expense | 12976631 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 57 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 275 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | KY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | WILL JONES CPA | NamePerson |
| Telephone Number | 2709655281 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 W GUM STREET | AddressLine1 |
| City | MARION | City |
| State | KY | State |
| ZIP Code | 42064 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| CHARLIE HUNT | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| ROGER SIMPSON | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DR GREG MADDUX | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| VALERIE NEWCOM | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| HUGH HIGHFIL | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| WADE BERRY | |||||||
| VICE-CHAIR | 1.0 | X | 0 | 0 | 0 | X | |
| BART FRAZER | |||||||
| CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | |
| JEAN CLAUDE KIEFFER | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| CARL J CHRISTENSEN | |||||||
| CEO | 40.0 | 133205 | 0 | 20469 | X | ||
| THOMAS MORIN HALES | |||||||
| PART YEAR CFO 06/10/11-9/30/11 | 40.0 | 0 | 0 | 0 | X | ||
| ANN NEWCOM | |||||||
| PART YEAR CFO 12/1/10-6/10/11 | 40.0 | 51024 | 0 | 15011 | X | ||
| JOSEPH ALLEN SWAB | |||||||
| PART YEAR CFO 10/1 - 12/01/10 | 40.0 | 114322 | 0 | 15011 | X | ||
| TERRY DURHAM | |||||||
| CRNA | 40.0 | 175613 | 0 | 22157 | X | ||
| STUART COLLINS | |||||||
| PHARMACIST | 40.0 | 145667 | 0 | 21086 | X | ||
| DR STEVEN MAYFIELD | |||||||
| PHYSICIAN | 40.0 | 149536 | 0 | 15011 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 769367 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 108745 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SYSTEMS SOLUTIONS | |||||
| 115 CARLISLE COURT | PADUCAH | KY | 42001 | HARDWARE SUPPORT | 144000 |
| AMY RATLEY MD | |||||
| 1876 BETHEL CHURCH ROAD | MORGANFIELD | KY | 42437 | ER PHYSICIAN | 134760 |
| THOMAS ROUSSEAU MD | |||||
| 914 TURNBURY DRIVE | PRINCETON | KY | 42445 | ER PHYSICIAN | 174150 |
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | SOFTWARE SUPPORT | 144000 |
| GE MEDICAL SYSTEMS | |||||
| PO BOX 96483 | CHICAGO | IL | 60693 | MAINTENANCE | 206923 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 23285 | AllOtherContributions |
| Total Contributions | 23285 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 13556906 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13556906 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13556906 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 52258 | TotalRevenueColumn |
| Exclusion | $52,258 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 15420 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 15420 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15420 | TotalRevenueColumn |
| Exclusion | $15,420 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3775 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3775 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3775 | TotalRevenueColumn |
| Exclusion | $3,775 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| CONTRACTED THERAPY SERVICES | 621110 | 553647 | 553647 | |
| EHR INCENTIVES | 900099 | 198753 | $198,753 | |
| MEALS | 722210 | 64971 | $64,971 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 265037 | TotalRevenueColumn |
| Exclusion | $265,037 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1082408 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14734052 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14110553 | RelatedOrExemptFunctionIncome |
| Exclusion | $600,214 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 391899 | Total |
| Management And General | 391899 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7672593 | Total |
| Program Services | 7481527 | ProgramServices |
| Management And General | 191066 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 198302 | Total |
| Program Services | 183967 | ProgramServices |
| Management And General | 14335 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1131102 | Total |
| Program Services | 1049337 | ProgramServices |
| Management And General | 81765 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 562094 | Total |
| Program Services | 521461 | ProgramServices |
| Management And General | 40633 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25480 | Total |
| Management And General | 25480 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68135 | Total |
| Management And General | 68135 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1174567 | Total |
| Program Services | 1102696 | ProgramServices |
| Management And General | 71871 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24602 | Total |
| Program Services | 8758 | ProgramServices |
| Management And General | 15844 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261698 | Total |
| Program Services | 210027 | ProgramServices |
| Management And General | 51671 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 238507 | Total |
| Program Services | 238507 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214474 | Total |
| Program Services | 214474 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106182 | Total |
| Program Services | 103635 | ProgramServices |
| Management And General | 2547 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3083 | Total |
| Management And General | 3083 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 666035 | Total |
| Program Services | 11507 | ProgramServices |
| Management And General | 654528 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 282375 | Total |
| Program Services | 24836 | ProgramServices |
| Management And General | 257539 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 1276145 | 1255004 | 21141 |
| REPAIRS & MAINTENANCE | 445632 | 445011 | 621 |
| LICENSES & TAXES | 332633 | 140 | 332493 |
| COLLECTION | 60712 | 60712 | |
| DUES & SUBSCRIPTIONS | 70164 | 36975 | 33189 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84099 | Total |
| Program Services | 28057 | ProgramServices |
| Management And General | 56042 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15290513 | Total |
| Program Services | 12976631 | ProgramServices |
| Management And General | 2313882 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2350178 | BOY |
| EOY | 1216771 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1679320 | BOY |
| EOY | 1396144 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1390691 | BOY |
| EOY | 2171323 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 338781 | BOY |
| EOY | 349282 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 299005 | BOY |
| EOY | 278887 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 20133147 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15013095 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3614797 | BOY |
| EOY | 5120052 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 236761 | BOY |
| EOY | 223957 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9909533 | BOY |
| EOY | 10756416 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1341622 | BOY |
| EOY | 1393615 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1323686 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17131 | BOY |
| EOY | 12711 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1015173 | BOY |
| EOY | 1047258 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2373926 | BOY |
| EOY | 3777270 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3937941 | BOY |
| EOY | 3195491 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3597666 | BOY |
| EOY | 3783655 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7535607 | BOY |
| EOY | 6979146 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9909533 | BOY |
| EOY | 10756416 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -556461 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $3,481 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3481 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LOBBYING EXPENSES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1I | ReturnReference |
| Explanation | THE HOSPITAL PAYS DUES TO THE KENTUCKY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44408 | OtherCostOrOtherBasis |
| Book Value | 44408 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4994246 | OtherCostOrOtherBasis |
| Depreciation | 3841964 | Depreciation |
| Book Value | 1152281 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 892272 | OtherCostOrOtherBasis |
| Depreciation | 614033 | Depreciation |
| Book Value | 278239 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12625555 | OtherCostOrOtherBasis |
| Depreciation | 10140150 | Depreciation |
| Book Value | 2485405 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1576667 | OtherCostOrOtherBasis |
| Depreciation | 416948 | Depreciation |
| Book Value | 1159719 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5120052 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO THIRD PARTY PAYERS | Description |
| Amount | $1,047,258 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1047258 | TotalOfAmounts |
| Total Revenue | 14734052 | TotalRevenue |
| Total Expenses | 15290513 | TotalExpenses |
| Excess Or Deficit For Year | -556461 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -556461 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 14730277 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 14730277 | RevenueSubtotal |
| Other Revenues Not Included | 3775 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 3775 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 14734052 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15286738 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -3775 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -3775 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15290513 | ExpensesSubtotal |
| Total Expenses Per Form990 | 15290513 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | RECONCILIATION TO AUDIT REPORT | Identifier |
| Return Reference | SCH D, PART XII LINE 4B & PART XIII LINE 2D | ReturnReference |
| Explanation | GAIN ON DISPOSAL NETTED AGAINST EXPENSE PER AUDIT $3,775 | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 643145 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 199140 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 444005 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02900 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1638358 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1043335 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 595023 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03890 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2281503 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1242475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1039028 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06790 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6650 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14650 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 14650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2296153 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1242475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1053678 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06880 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $474,000 | BadDebtExpenseAmount |
| Amount Attributable To | 237000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7169168 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6810778 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 358390 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENDEN HEALTH SYSTEMS | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 WEST GUM ST | AddressLine1 |
| City | MARION | City |
| State | KY | State |
| ZIP Code | 42064 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENDEN HEALTH SYSTEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Burkhart Rural Health Clinic | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 East Main Street | AddressLine1 |
| City | Salem | City |
| State | KY | State |
| ZIP Code | 42078 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | Rural Health Clinic | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CHARITY CARE | SCH H, PART I, LINE 3C | THE HOSPITAL USED A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H. THE HOSPITAL USED ACTUAL COSTS AS REPORTED IN THE GENERAL LEDGER SYSTEM TO DETERMINE THE AMOUNTS ON LINES 7E OF PART I OF SCHEDULE H. |
| BAD DEBTS | SCHEDULE H, PART III, LINE 4 | THE HOSPITAL CALCULATED BAD DEBT EXPENSE AT COST USING THE COST TO CHARGE RATIO AS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED. THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE THAT SPECIFICALLY ADDRESSES BAD DEBTS. HOWEVER, THE PROVISION FOR BAD DEBTS IS INCLUDED IN THE NET PATIENT SERVICE REVENUE NOTE. THE PROVISION FOR BAD DEBTS REPRESENTS UNCOMPENSATED CARE FOR PATIENTS OF WHICH A MAJORITY ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE. THE HOSPITAL ESTIMATED THAT APPROXIMATELY 50% OF BAD DEBT EXPENSE MAY ACTUALLY QUALIFY FOR CHARITY CARE BASED ON THE FINANCIAL COLLECTOR'S KNOWLEDGE AND EXPERIENCE. APPROXIMATELY 25% OF THE CHARITY APPLICATIONS SENT OUT DO NOT RESPOND AND APPROXIMATELY 25% THAT DO RESPOND ARE UNCOOPERATIVE AND OFTEN DO NOT BRING IN ALL DOCUMENTATION REQUIRED TO SUPPORT QUALIFICATION BASED ON THE CHARITY CARE POLICY. |
| MEDICARE | SCHEDULE H, PART III, LINE 8 | FISCAL YEAR 2011 MEDICARE COST REPORT WAS USED TO DETERMINE THE UNPAID COST OF MEDICARE. UNPAID COST OF MEDICARE REPRESENTS THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. |
| COLLECTION PRACTICES | SCHEDULE H, PART III, LINE 9B | CRITTENDEN COUNTY HOSPITAL APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH CHARITY CARE ELIGIBLE AND NON-CHARITY CARE PATIENTS. THE PROCEDURES FOR COLLECTION ON PATIENT ACCOUNTS ARE AS FOLLOWS: POLICY: CHS WILL REQUEST DEPOSITS AND/OR PAYMENT ARRANGEMENTS FOR PATIENT SERVICES NOT COVERED BY INSURANCE OR OTHER PAYMENT SOURCES. IMPLEMENTATION: PATIENTS CONTACTED FOR CENTRALIZED SCHEDULING. THE SCHEDULER IS NOTIFIED OF PATIENTS WITHOUT INSURANCE UNLESS CLINICALLY NECESSARY TO DO SO. OTHERWISE, SELF-PAY PATIENTS SHOULD BE SCHEDULED A FEW EXTRA DAYS OUT TO PROVIDE EXTRA TIME TO CONTACT THEM FOR PRE-SERVICE COLLECTION. PROCESS: THOSE PATIENTS WILL BE CONTACTED, AND THEN BE INFORMED OF THE NECESSARY INFORMATION FOR FINANCIAL SCREENING (PROOF OF INCOME, EMPLOYMENT INFORMATION, ETC), REQUESTED TO COME IN EARLY ON THE DAY OF SERVICES, AND REQUESTED TO BRING SOME METHOD OF PAYMENT (CASH,CHECK,CREDIT CARD,ETC.) ON THAT DAY. ER PATIENTS: PATIENTS SHOULD RECEIVE THE REQUIRED MEDICAL SCREENING AFTER THE BASIC PATIENT INFORMATION IS OBTAINED (NAME, DATE OF BIRTH AND SOCIAL SECURITY NUMBER SHOULD BE OBTAINED IF THE PATIENT'S MEDICAL CONDITION PERMITS). IF A PATIENT IS WAITING TO RECEIVE MEDICAL CARE, THE PATIENT MAY BE REGISTERED, HOWEVER THE PATIENT'S MEDICAL SCREENING SHOULD NEVER BE DELAYED FOR THE REGISTRATION PROCESS. SEE BELOW FOR NEXT STEPS. ER PATIENTS DEEMED URGENT AFTER MEDICAL SCREENING - PATIENTS DEEMED URGENT FOR ADDITIONAL CARE AFTER THE MEDICAL SCREENING WILL BE DETERMINED BY THE PROFESSIONAL JUDGEMENT OF THE PHYSICIAN OR PA COVERING THE ER. HOSPITAL STAFF WILL PROVIDE NECESSARY CARE TO MEDICALLY STABILIZE THE PATIENT AND THE PATIENT WILL BE REGISTERED WHENEVER POSSIBLE. AFTER THE PATIENT IS MEDICALLY STABILIZED THE PATIENT WILL BE ASKED FOR A DEPOSIT AND/OR PAYMENTS ON OLD ACCOUNTS, ASKED TO SET UP PAYMENT ARRANGEMENTS FOR ANY BALANCES, AND SELF-PAY PATIENTS WILL BE SCREENED FOR CHARITY AND POSSIBLE MEDICAID ELIGIBILITY AS SOON AS PRACTICAL. PHYSICIAN REFERRALS (INCLUDING THOSE VIA CENTRALIZED SCHEDULING) OR PATIENTS WITHOUT EMERGENCY MEDICAL CONDITIONS AFTER MEDICAL SCREENING - THE PATIENT WILL BE REGISTERED. AFTER REGISTRATION THE FOLLOWING SHOULD OCCUR: CHECK FOR PRIOR ACCOUNT BALANCES. PATIENTS WITH UNPAID BALANCES MORE THAN 90 DAYS OLD WILL BE REQUIRED TO MAKE A DEPOSIT AND SET UP PAYMENT ARRANGEMENTS ON THOSE OLD ACCOUNTS PRIOR TO RECEIVING ANY ADDITIONAL SERVICE FOR NON-EMERGENCY MEDICAL CONDITIONS. CHARITY SCREENING PAPERWORK: ALL SELF-PAY PATIENTS SHOULD BE SCREENED FOR CHARITY AND MEDICAID CRITERIA BASED ON THE RESPONSIBLE PARTY'S INCOME COMPARED TO THE GUIDELINES IN THE CHARITY POLICY. ALL OR PART OF THE PATIENT'S CHARGES MAY BE WRITTEN OFF. PATIENTS REFUSING TO COMPLETE CHARITY SCREENING PAPERWORK WILL BE CONSIDERED TO NOT QUALIFY. PATIENTS NOT MEETING CHARITY CRITERIA WILL BE REQUIRED TO MAKE A DEPOSIT FOR SERVICES (ACCORDING TO THE ESTABLISHED SCHEDULE) AND AGREE TO PAYMENT ARRANGEMENTS FOR THE BALANCE. CHS EMPLOYEES: EMPLOYEES OF CHS SHOULD SIGN A PAYROLL DEDUCTION AUTHORIZATION TO PAY FOR ANY COSTS NOT COVERED BY INSURANCE. PATIENTS WITHOUT NECESSARY FUNDS FOR REQUIRED DEPOSIT, NOT REQUIRING EMERGENCY SERVICES, WILL BE ASKED TO CONTACT POSSIBLE PAYMENT SOURCES (FRIENDS, RELATIVES, ETC) ON AN EXCEPTION BASIS APPROVED BY THE CEO OR CFO. IF ADEQUATE FUNDS WILL NOT BE AVAILABLE FOR THE REQUIRED DEPOSIT, THE PATIENT WILL BE ASKED TO SIGN AN AGREEMENT TO MAKE MONTHLY PAYMENTS, WHICH WILL INCLUDE AN AGREEMENT WHICH CAN BE SUBMITTED TO THEIR EMPLOYER (OR THE EMPLOYER OF THE SPOUSE OR GUARANTOR) WHERE THEY WILL AGREE TO MAKE MINIMUM MONTHLY PAYMENTS TO CHS, WHICH WILL BE SUBMITTED TO THE EMPLOYER IF THE MONTHLY PAYMENTS ARE NOT DIRECTLY SUBMITTED TO CHS. NOTE, PATIENTS WITHOUT SOME FORM OF EMPLOYMENT (FOR THEM OR GUARANTOR) WOULD GENERALLY QUALIFY FOR CHARITY. INDIVIDUALS WHO WILL NOT MAKE THE DEPOSIT OR AGREE TO PAYMENTS FROM THEIR EMPLOYER WILL BE ASKED TO RETURN FOR NON-EMERGENCY SERVICES WHEN THEY ARE WILLING TO PROVIDE ONE OF THESE PAYMENTS SOURCES. PATIENTS WHO ARE REFUSED SERVICES: THESE ARE PATIENTS WHO DO NOT QUALIFY CHARITY CARE AND WHO DO NOT PROVIDE A DEPOSIT AND/OR AGREE TO THE ABOVE. NOTED PAYMENT ARRANGEMENTS: PHYSICIAN'S OFFICE WILL BE NOTIFIED AS SOON AS POSSIBLE IF A PATIENT REFERRAL IS TURNED AWAY DUE TO LACK OF PAYMENT. IF PHYSICIAN REQUESTS THE SERVICES BE PROVIDED DESPITE LACK OF PAYMENT THE ADMINISTRATOR ON CALL WILL BE NOTIFIED AND SERVICES WILL BE PROVIDED. THE DEPOSIT SCHEDULE WILL BE UPDATED AT LEAST ANNUALLY AS APPROVED BY THE CEO AND CFO, WITHIN THE TERMS OF THE POLICY. GENERALLY FOR SERVICES PROVIDED SOLELY BY CHS THE REQUIRED DEPOSIT WILL BE BETWEEN 20% AND 50% OF EXPECTED NORMAL CHARGES FOR SERVICES PROVIDED BY EXTERNAL SOURCES, WHICH CHS HAS TO PAY A FEE PER SERVICE,THE DEPOSIT WILL BE AT LEAST THE AMOUNT CHARGED TO CHS BY THE OUTSIDE VENDOR (THIS INCLUDES SLEEP LAB AND NUCLEAR MEDICINE). PAYMENT BASED ON POVERTY LEVEL GUIDELINES: AS NOTED IN THE CHARITY POLICY, EXCEPTIONS TO THE DEPOSIT REQUIREMENTS ARE AS FOLLOWS BASED ON INCOME COMPARED TO THE MOST RECENT FEDERAL POVERTY LEVELS 0-100% ALL CHARGES TO BE FORGIVEN, NO DEPOSIT REQUIRED 101-200% NO DEPOSIT REQUIRED AT THE TIME OF SERVICES 201-300% THE DEPOSIT AT THE TIME OF SERVICE TO NOT EXCEED $25 |
| NEEDS ASSESSMENT | SCHEDULE H, PART VI, LINE 2 | CRITTENDEN COUNTY HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY THROUGH SEVERAL AVENUES, INVOLVING HOSPITAL EMPLOYEES FROM VARIOUS DEPARTMENTS OF THE HOSPITAL. THE MISSION IS TO PROVIDE ONGOING ASSESSMENTS OF THE HEALTHCARE NEEDS OF CRITTENDEN COUNTY AND THE SURROUNDING COMMUNITIES AND STRIVE TO MEET THE NEEDS IDENTIFIED. THE HOSPITAL ALSO UNDERWENT A STRATEGIC PLAN AND MARKET ANALYSIS IN 2009 WITH QHR WHICH PROVIDED VALUABLE INFORMATION LINKING THE HOSPITAL STRATEGIC PLAN WITH SPECIAL ATTENTION GIVEN TO THOSE MOST IN NEED IN THE COMMUNITY. ALSO IN 2009, THE HOSPITAL WENT THROUGH A COMMUNITY HEALTH ASSESSMENT THROUGH THE DELTA RURAL HEALTH PROJECT. THE VP OF HUMAN RESOURCES SERVES ON THE DRUG COALITION BOARD. THE PHARMACY DIRECTOR AND INFECTION CONTROL DIRECTOR SERVE ON THE BOARD OF DIRECTORS FOR THE CRITTENDEN COUNTY HEALTH DEPARTMENT. THE HOSPITAL IS ACTIVE IN THE SPEAKER'S BUREAU AND OFFERS COMMUNITY EDUCATION CLASSES. PARTICIPATION IN EACH OF THESE GROUPS ASSISTS THE HOSPITAL IN CONTINUALLY ASSESSING THE NEEDS OF THE COMMUNITY. IN ADDITION, NEEDS ASSESSMENTS ARE ON-GOING THROUGH THE VARIOUS PROGRAMS AND SERVICES PROVIDED TO THE COMMUNITY BY THE HOSPITAL AS FOLLOWS: -SPEAK TO SENIOR CITIZENS GROUPS ON A VARIETY OF HEALTHCARE TOPICS -SPEAK TO SCHOOL CLASSES ABOUT HEALTHY LIVING AND HEALTHCARE TOPICS THROUGH CAREER WEEK AND THE SCHOOL REALITY STORE -OFFER CPR CLASSES TO THE PUBLIC AND TO AREA BUSINESSES FOR THEIR EMPLOYEES -PROVIDE TOURS OF THE HOSPITAL TO STUDENT AND CIVIC GROUPS -COOPERATIVE AGREEMENT WITH THE HEALTH OCCUPATIONS CLASS -CLINICAL SITE FOR PHYSICAL THERAPY, RESPIRATORY, ANESTHESIA, AND RADIOLOGY STUDENTS -SPONSOR SIX CHAMPIONS FOR LIFE BLOOD DRIVES EACH YEAR -OFFER BLOOD PRESSURE CHECKS AT VARIOUS EVENTS THROUGHOUT THE YEAR -HOST A FREE WOMEN'S CONFERENCE ANNUALLY -PROVIDE A $650 SCHOLARSHIP ANNUALLY -PARTICIPATE ANNUALLY IN THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE -PROVIDE AMBULANCE COVERAGE FOR VARIOUS SPORTING EVENTS (FOOTBALL GAMES) -PROVIDE AMBULANCE COVERAGE FOR CRITTENDEN COUNTY FAIRS (RODEOS, DEMOLITION DERBY, MOTORCYCLE RACES, ETC) -PARTICIPATE IN THE SCHOOL MENTORING PROGRAM -STAFF REPRESENTATION ON NUMEROUS COMMUNITY COMMITTEES -SPONSOR VARIOUS CHAMBER AND COMMUNITY ACTIVITIES |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION REGARDING ELIGIBILITY FOR ASSISTANCE PROVIDED IN THE FOLLOWING MEDIUMS: DHS APPS ARE SIGNED IN ADMITTING AND FORWARDED TO DMC TO QUALIFY - POSTED IN ADMITTING - PATIENTS ARE CONTACTED BY A PATIENT ACCOUNTS REPRESENTATIVE DURING THEIR HOSPITAL STAY REGARDING ELIGIBILITY FOR ASSISTANCE. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4 | CRITTENDEN COUNTY IS A RURAL AREA WITH A REPORTED POPULATION OF 9,384. THE MEDIAN INCOME FOR A HOUSEHOLD INCOME (IN 2000 CENSUS) WAS $29,060 AND THE MEDIAN INCOME FOR A FAMILY WAS $36,462. AGE DISTRIBUTION OF POPULATION IN THE PRIMARY SERVICE AREA IN YEAR 2000 CENSUS INCLUDED: UNDER 5(5.4%), 5-9(6.4%), 10-14(7.2%), 15-19(7%), 20-24(5.2%), 25-34(11.4%), 35-44(14.7%), 45-54(13.9%), 55-59 (7.1%), 60-64(5.4%), 65-74(8.3%), 75-84(5.9%) AND OVER 85(2.1%) ADJACENT COUNTIES INCLUDE UNION, WEBSTER, CALDWELL, LYON, LIVINGSTON AND HARDIN COUNTY, ILLINOIS. OF THESE COUNTIES, UNION, CALDWELL AND LIVINGSTON ALL HAVE ONLY A CRITICAL ACCESS HOSPITAL. THE OTHER THREE, WEBSTER, LYON AND HARDIN COUNTY, ILLINOIS DO NOT HAVE A HOSPITAL WITHIN THE COUNTY (SOURCES: US CENSUS BUREAU). |
| COMMUNITY BUILDING ACTIVITIES | SCHEDULE H, PART VI, LINE 5 | CRITTENDEN COUNTY HOSPITAL PROVIDES ACTIVITIES AND SERVICES FOR WHICH NO PATIENT BILL EXISTS. THESE SERVICES ARE NOT EXPECTED TO BE FINANCIALLY SELF-SUPPORTING, ALTHOUGH SOME MAY BE SUPPORTED BY OUTSIDE GRANTS OR FUNDING. THE HOSPITAL EMPLOYEES ALSO COLLECT MONEY OR FOOD ON AN ANNUAL BASIS FOR THE LOCAL COMMUNITY CHRISTMAS WHERE THEY ALSO PROVIDE PRESENTS FOR FAMILIES PARTICIPATING IN THE CHRISTMAS ANGEL PROGRAM. THE HOSPITAL OFFERS A HEALTH FAIR FOR THE COMMUNITY, PROVIDING FREE OR REDUCED PRICING SCREENINGS (BLOOD PRESSURE, CHILD ID, LIPID PROFILE, BLOOD GLUCOSE) AND HEALTH INFORMATION. THE HOSPITAL PROVIDES A HEALTH FAIR FOR PAR 4 (MANUFACTURING COMPANY) EMPLOYEES, CRITTENDEN COUNTY HOSPITAL AMERICAN CANCER SOCIETY, SPECIAL OLYMPICS, AND CYSTIC FIBROSIS. THE HOSPITAL OFFERS DISCOUNTED MAMMOGRAMS DURING THE MONTH OF OCTOBER IN HONOR OF BREAST CANCER AWARENESS MONTH. THE HOSPITAL SUPPLIES A REGISTERED NURSE FOR 4-H CAMP FOR AREA SCHOOL CHILDREN. THE REGISTERED NURSE MAINTAINS A FIRST AID STATION THROUGHOUT THE CAMP. THE HOSPITAL PROVIDED BLOOD PRESSURE CHECKS AT SEVERAL COMMUNITY EVENTS. THE HOSPITAL HOSTS SEVERAL BLOOD DRIVES AT THER FACILITY EACH YEAR. CRITTENDEN COUNTY HAS A CHARITY CARE PROGRAM FOR HOSPITAL CLIENTELE. THE HOSPITAL HAS WRITTEN OFF $962,639 IN UNCOLLECTABLE ACCOUNTS IN FISCAL YEAR 2011 FOR PATIENTS IT DEEMS UNABLE TO PAY FOR HEALTHCARE SERVICES UNDER ITS CHARITY CARE POLICY. CRITTENDEN COUNTY HOSPITAL ACCEPTS PATIENTS WITHOUT REGARD FOR THEIR ABILITY TO PAY FOR CARE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARL J CHRISTENSEN | |||||||||||||
| 133205 | 0 | 0 | 0 | 0 | 0 | 5458 | 0 | 15011 | 0 | 153674 | 0 | 0 | 0 |
| TERRY DURHAM | |||||||||||||
| 175613 | 0 | 0 | 0 | 0 | 0 | 7146 | 0 | 15011 | 0 | 197770 | 0 | 0 | 0 |
| STUART COLLINS | |||||||||||||
| 145667 | 0 | 0 | 0 | 0 | 0 | 6075 | 0 | 15011 | 0 | 166753 | 0 | 0 | 0 |
| DR STEVEN MAYFIELD | |||||||||||||
| 149536 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15011 | 0 | 164547 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| County of Crittenden Series 2011A | |||||||
| 616000867 | 000000000 | 2011-06-01 | 2104000 | Construct,renovate and equip a sur | false | false | false |
| County of Crittenden Series 2011B | |||||||
| 616000867 | 000000000 | 2011-06-01 | 1020982 | Construct,renovate and equip a sur | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|
| 2104000 | 835992 | 1268008 | false | false | false | true |
| 1020982 | 487694 | 533288 | false | false | false | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| false | false | false | false | true | 0.00000 | 0.00000 | 0.00000 | true |
| false | false | false | false | true | 0.00000 | 0.00000 | 0.00000 | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| false | false | false | false | false | true |
| false | false | false | false | false | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Schedule K Part V | Form990ScheduleKPartV |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCESS TO REVIEW FORM 990 | FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. A COPY OF THE FORM 990 IS THEN EMAILED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. |
| MONITORING THE CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST FORMS ARE COMPLETED ANNUALLY BY THE GOVERNING BODY AND REVIEWED BY ADMINISTRATION. ANY POTENTIAL CONFLICTS ARE ADDRESSED. |
| PROCESS FOR DETERMINING COMPENSATION | FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S COMPENSATION IS EVALUATED AND DETERMINED BY THE BOARD OF DIRECTORS |
| MAKING DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990, PART VI, SECTION C, LINE 19 | SELECTED FINANCIAL INFORMATION IS MADE AVAILABLE ANNUALLY AT A PUBLIC MEETING. OTHER DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENDEN HEALTH SYSTEMS FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 386 | AddressLine1 |
| City | MARION | City |
| State | KY | State |
| ZIP Code | 42064 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262053982 | EIN |
| Primary Activities | PHILANTHROPY | PrimaryActivities |
| Legal Domicile State | KY | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |