TCRH INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
TCRH INC (EIN 54-6075662)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-03
IRS object ID
201102159349300430
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-03T12:32:10-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 FRANKLIN RD SE SUITE 501AddressLine1
CityROANOKECity
StateVAState
ZIP Code240112114ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN546075662EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TWIN COUNTY REGIONAL HEALTHCARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlTWINNameControl
Phone2762368181Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HOSPITAL DRIVEAddressLine1
CityGALAXCity
StateVAState
ZIP Code24333ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNelson MontgomeryName
Titleacting cfoTitle
Phone2762368181Phone
Date Signed2011-07-25DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMichael P NortonName
Phone5409896144Phone
Date Prepared2011-07-25DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonNelson MontgomeryNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 HOSPITAL DRIVEAddressLine1
CityGalaxCity
StateVAState
ZIP Code24333ZIPCode
FieldValueIRS element (for citing)
Gross Receipts49163225GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.tcrh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1973YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionTo promote, preserve, and restore the health of our community.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees653TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1631ContributionsGrantsPriorYear
Contributions Grants Current Year56214ContributionsGrantsCurrentYear
Program Service Revenue Prior Year52257028ProgramServiceRevenuePriorYear
Program Service Revenue CY48426007ProgramServiceRevenueCY
Investment Income Prior Year167126InvestmentIncomePriorYear
Investment Income Current Year161300InvestmentIncomeCurrentYear
Other Revenue Prior Year483295OtherRevenuePriorYear
Other Revenue Current Year519704OtherRevenueCurrentYear
Total Revenue Prior Year52909080TotalRevenuePriorYear
Total Revenue Current Year49163225TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year28661334SalariesEtcPriorYear
Salaries Etc Current Year27558751SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year22955231OtherExpensePriorYear
Other Expenses Current Year23406532OtherExpensesCurrentYear
Total Expenses Prior Year51616565TotalExpensesPriorYear
Total Expenses Current Year50965283TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1292515RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1802058RevenuesLessExpensesCY
Total Assets BOY27436549TotalAssetsBOY
Total Assets EOY23464311TotalAssetsEOY
Total Liabilities BOY14527874TotalLiabilitiesBOY
Total Liabilities EOY14441743TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12908675NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9022568NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide health services for residents in the surrounding areas of rural southwest virginia.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense29050210Expense
Grants56214Grants
Revenue49107011Revenue
DescriptionPATIENT SERVICES PROVIDED BY A 141 BED HOSPITAL including rural health clinics, operating room, pharmacy services, home health services, CORONARY CARE, OCCUPATIONAL tHERAPY, REPIRATORY THERAPY,pHYSICAL THERAPY AND HEALTH PROMOTION.Description
Total Program Service Expense29050210TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109670NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees653NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5402368181TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 HOSPITAL DRIVEAddressLine1
CityGALAXCity
StateVAState
ZIP Code24333ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
John W Bolen Jr
Director1.00X000
James Griffeth
Chief of Staff (ex-officio)1.00X000
Rebecca W Cardwell
Director1.00X000
William L Davis
Director1.00X000
Blake M Edwards
Vice CHairman1.00X000
joseph killon
Director1.00X000
oliver mcbride
Director1.00X000
Edward A Hanks II
Director1.00X000
Barry mayberry
Director1.00X000
Robert E Pryor
Director1.00X000
William R Roberts
Director1.00X000
Larry G South
Director1.00X000
Taylor C Vaughan
Director1.00X000
Douglas S Vaught
cHAIRMAN1.00X000
c m mitchell
Director1.00X000
Jon Applebaum
President/CEO/Secretary/Tr40.00X181262019608X
Sandra Moretz
VP of Nursing/COO40.00133757012681X
Nelson montgomery
VP of Finance/CFO40.00120225020044X
Dianne Dill
CRNA40.00160932012619X
Michael Shanks
CRNA40.00169870022809X
Mitch Mize
CRNA40.00152630022955X
JAMES HELMS
CRNA40.00157513020412X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1076189TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation131128TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CARDINAL HEALTH PHARMACY MGMT
21377 NETWORK PLACECHICAGOIL60673PHARMACY885585
EPMG of Virginia PC
2000 Green RoadAnn ArborMI48105emergency department services575135
aramark cts
12483 COLLECTIONS CENTER DRIVECHICAGOIL60693biomedical services488555
Hospital Revenue Cycle Mgmt
4140 CLEMMONS ROAD SUITE 202CLEMMONSNC27012Patient Accounting Services435599
Johnston Memorial Hospital
351 Court Street NEAbingdonVA24210Blood Bank329672
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
All Other Contributions56214AllOtherContributions
Total Contributions56214TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Ancillary revenue-nET6241003636034236360342
Room and Board6241001206566512065665
FieldValueIRS element (for citing)
Total Program Service Revenue48426007TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column161300TotalRevenueColumn
Exclusion$161,300ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real149167Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real149167Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column149167TotalRevenueColumn
Related Or Exempt Function Income149167RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafeteria and Vending900099213412213412
Miscellaneous9000996614966149
Gift Shop Sales9000995770757707

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column33269TotalRevenueColumn
Related Or Exempt Function Income33269RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue370537TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column49163225TotalRevenueColumn
Related Or Exempt Function Income48945711RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$161,300ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1076189Total
Program Services613428ProgramServices
Management And General462761ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21451223Total
Program Services12227197ProgramServices
Management And General9224026ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total550478Total
Program Services313772ProgramServices
Management And General236706ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2842515Total
Program Services1620234ProgramServices
Management And General1222281ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1638346Total
Program Services933857ProgramServices
Management And General704489ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total192579Total
Program Services109770ProgramServices
Management And General82809ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total46427Total
Program Services26463ProgramServices
Management And General19964ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total106745Total
Program Services60845ProgramServices
Management And General45900ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2632074Total
Program Services1500282ProgramServices
Management And General1131792ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total39665Total
Program Services22609ProgramServices
Management And General17056ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total134057Total
Program Services76412ProgramServices
Management And General57645ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1389416Total
Program Services791967ProgramServices
Management And General597449ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total379022Total
Program Services216043ProgramServices
Management And General162979ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total521004Total
Program Services296972ProgramServices
Management And General224032ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1810296Total
Program Services1031869ProgramServices
Management And General778427ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total339718Total
Program Services193639ProgramServices
Management And General146079ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies661959337731682846425
Bad Debt Expense472676126942542032507
Purchased Services1157502659776497726
Contract Labor1090518621595468923
Equipment Rental871914496991374923

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1349241Total
Program Services769067ProgramServices
Management And General580174ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total50965283Total
Program Services29050210ProgramServices
Management And General21915073ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6053378BOY
EOY3590527EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1395428BOY
EOY1052630EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5637888BOY
EOY5536113EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1199824BOY
EOY1149963EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY349921BOY
EOY361013EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis47621151LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec37015183LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11840096BOY
EOY10605968EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY960014BOY
EOY1168097EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27436549BOY
EOY23464311EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4944611BOY
EOY6084582EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY9254485BOY
EOY7976257EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY328778BOY
EOY380904EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14527874BOY
EOY14441743EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12908675BOY
EOY9022568EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12908675BOY
EOY9022568EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27436549BOY
EOY23464311EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis274349InvestmentCostOrOtherBasis
Book Value274349BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis20034846InvestmentCostOrOtherBasis
Depreciation13676242Depreciation
Book Value6358604BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis112123InvestmentCostOrOtherBasis
Depreciation102310Depreciation
Book Value9813BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis26420986InvestmentCostOrOtherBasis
Depreciation22504484Depreciation
Book Value3916502BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis778847InvestmentCostOrOtherBasis
Depreciation732147Depreciation
Book Value46700BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10605968TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Est MC/MCaid Settlement$172,763
Federal Income Tax Withheld$90,325
FICA Taxes Withheld$117,816
FieldValueIRS element (for citing)
Total Of Amounts380904TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available0ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1762351TotalCommunityBenefitExpense
Net Community Benefit Expense1762351NetCommunityBenefitExpense
Percent Of Total Expense0.03460PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6406187TotalCommunityBenefitExpense
Direct Offsetting Revenue4294633DirectOffsettingRevenue
Net Community Benefit Expense2111554NetCommunityBenefitExpense
Percent Of Total Expense0.04140PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8168538TotalCommunityBenefitExpense
Direct Offsetting Revenue4294633DirectOffsettingRevenue
Net Community Benefit Expense3873905NetCommunityBenefitExpense
Percent Of Total Expense0.07600PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs46NumberOfActivitiesOrPrograms
Persons Served1203PersonsServed
Total Community Benefit Expense102674TotalCommunityBenefitExpense
Net Community Benefit Expense102674NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense12551TotalCommunityBenefitExpense
Net Community Benefit Expense12551NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Total Community Benefit Expense6395TotalCommunityBenefitExpense
Net Community Benefit Expense6395NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs55NumberOfActivitiesOrPrograms
Persons Served1203PersonsServed
Total Community Benefit Expense121620TotalCommunityBenefitExpense
Net Community Benefit Expense121620NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs55NumberOfActivitiesOrPrograms
Persons Served1203PersonsServed
Total Community Benefit Expense8290158TotalCommunityBenefitExpense
Direct Offsetting Revenue4294633DirectOffsettingRevenue
Net Community Benefit Expense3995525NetCommunityBenefitExpense
Percent Of Total Expense0.07830PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Total Community Building Expense1587TotalCommunityBuildingExpense
Net Community Building Expense1587NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Total Community Building Expense1587TotalCommunityBuildingExpense
Net Community Building Expense1587NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,441,761BadDebtExpenseAmount
Amount Attributable To1538235AmountAttributableTo
Amount Reimbursed By Medicare22061312AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare24628442CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2567130MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Twin County Regional HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 Hospital DriveAddressLine1
CityGalaxCity
StateVAState
ZIP Code24222ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Annual Community Benefit ExplnPart I, Line 6a: An annual community benefit report is prepared by Twin County Regional Healthcare for inclusion in the Virginia Hospital and Healthcare Association.AnnualCommunityBenefitExpln
Bad Debt FootnotePart III, Line 4: The amounts in line 2-3 were derived based on the cost to charge ratio. Bad debt should be included in community benefit because we are providing a service to our community population that is either unable or unwilling to pay.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: Medicare makes up over 50% of our business. Any shortfall that results from the payments received being less than the cost of providing the service should be considered as a community benefit. For small, rural hospitals like us, this can have a huge financial impact.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: Twin County Regional Hospital does not pursue collection of amounts determined to qualify as charity care. The expenses incurred in providing these services are included in the hospital's operating expenses.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: Twin County Regional Healthcare has four community advisory boards; Galax City Advisory Board, Grayson County Advisory Board, Carroll County Advisory Board and the Hispanic Advisory Board. Each of these groups meets quarterly to discuss the needs of the areas citizens. Groups are made up of TCRH Board Members that live in the respective area, social services, local police departments, local physicians and other community leaders that have been identified. The groups make suggestions of needed services, express concerns regarding healthcare needs and poll the citizens for their opinions.NeedsAssessment
Patient Education AssistancePart VI, Line 3: Twin County Regional Healthcare has an eligibility worker in partnership with the local Department of Social Services, cashiers and collection representatives available to help patients determine their eligibility for Medicaid, charity care or other programs for which they meet the qualifications. Cashiers and collection representatives are also trained to help establish payment plans for patients who do not qualify for other assistance. TCRH also offers a pre-pay program which discounts some of the most popular services offered. Brochures are available at local physician offices and entry points at TCRH.PatientEducationAssistance
Community InformationPart VI, Line 4: Grayson and Carroll counties and the City of Galax are the main areas which Twin County Regional Hospital services. These counties are located in southwest Virginia. With populations of 15,793 for Grayson County, 29,034 for Carroll County and 6,880 for Galax City, it is a rural area with several local physician offices meeting the rural health status. Over 20% of Grayson Countys population is over 65 years of age, 64% of the population is a high school graduate and most citizens have a daily commute to work for 30 minutes. Carroll County has 18% of its population over age 65, 64 % of the population is a high school graduate and the average commute is 26 minutes. Galax City has a 20% population of over age 65, 60% of residents have a high school degree and have a 15 minute commute to work. The unemployment rate of the two counties is over 10% and most jobs in the are manufacturing and local government. In these counties, 14.8-19% of the population is below the poverty level.CommunityInformation
Community Building ActivitiesPart VI, Line 5: Twin County Regional Healthcare has representation of the Virginia Asthma Coalition, Roanoke Asthma Coalition and the Twin County Coalition. The Virginia Asthma Coalition and the Roanoke Asthma Coalition target Virginia and Southwest Virginia, respectively, in a project to improve asthma education for the area. Our cardiopulmonary department manager has worked with the Roanoke branch to help establish the project in our counties. The Twin County Coalition was organized to provide opportunities for prevention, recovery and support for various health issues, drug prevention, community education and many early childhood programs.CommunityBuildingActivities

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Jon Applebaum
1812620000060000136080200870000
Dianne Dill
1609320000000126190173551000
Michael Shanks
1698700000000228090192679000
Mitch Mize
1526300000000229550175585000
JAMES HELMS
1575130000000204120177925000

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionMEDICAL MONITORSDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99056214NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11The CFO reviews and signs the return.
Form 990, Part VI, Section B, line 15aWe have a compensation committee that is part of our board of directors. They are responsible for determining the compensation of the CEO.
Form 990, Part VI, Section C, line 18Copies are provided upon request
Form 990, Part VI, Section C, line 19Copies are provided upon request
form 990, part xi, line 2cthe review process has not changed during the year.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Twin County Family Care Center
200 Hospital DriveGalaxVA24333621455713Physican OfficeVA501(c)(3)Line 3Twin County Regional Healthcare Inc
Twin County Regional Health Services
200 Hospital DrivegalaxVA24333541397631Wellness CenterVA501(c)(3)Line 3Twin County Regional Healthcare Inc
Twin County Regional Foundation
200 Hospital DrivegalaxVA24333541593923FoundationVA501(c)(3)Line 11a, Itwin County Regional Healthcare Inc
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Twin County Regional Foundation
C56214
Twin County Family Care Centers
I135740

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