T J SAMSON COMMUNITY HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- T J SAMSON COMMUNITY HOSPITAL (EIN 61-0461767)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-11
- IRS object ID
- 201122239349301657
- Schema version
- 2009v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-11T10:12:47-07:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Taylor Polson & Company CPAs PSC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1804 | AddressLine1 |
| City | GLASGOW | City |
| State | KY | State |
| ZIP Code | 421421804 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610461767 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TJ Samson Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | TJSA | NameControl |
| Phone | 2706514444 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 NORTH RACE STREET | AddressLine1 |
| City | GLASGOW | City |
| State | KY | State |
| ZIP Code | 42141 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Anthony Sudduth | Name |
| Title | CFO | Title |
| Phone | 2706518877 | Phone |
| Date Signed | 2011-08-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Belinda Coulter | Name |
| Phone | 2706518877 | Phone |
| Date Prepared | 2011-08-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Bill Kindred CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 North Race Street | AddressLine1 |
| City | Glasgow | City |
| State | KY | State |
| ZIP Code | 42141 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 119421894 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.TJSAMSON.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1929 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | The organization provides medical care for Barren and the surrounding counties in Kentucky. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1073 | TotalNbrEmployees |
| Total Nbr Volunteers | 103 | TotalNbrVolunteers |
| Total Gross UBI | -1662 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1662 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 23723 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5000 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 116887980 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 116884206 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1070327 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1958704 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 424142 | OtherRevenuePriorYear |
| Other Revenue Current Year | 507329 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 118406172 | TotalRevenuePriorYear |
| Total Revenue Current Year | 119355239 | 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 | 58311362 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 59439542 | 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 | 50068813 | OtherExpensePriorYear |
| Other Expenses Current Year | 54759391 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 108380175 | TotalExpensesPriorYear |
| Total Expenses Current Year | 114198933 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 10025997 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5156306 | RevenuesLessExpensesCY |
| Total Assets BOY | 116436664 | TotalAssetsBOY |
| Total Assets EOY | 124226796 | TotalAssetsEOY |
| Total Liabilities BOY | 44491464 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 42087446 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 71945200 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 82139350 | NetAssetsOrFundBalancesEOY |
| Mission Description | TJ SAMSON COMMUNITY HOSPITAL WILL PROMOTE AND PROVIDE FOR THE HEALTH AND WELLBEING OF THOSE THEY SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 104448674 | Expense |
| Revenue | 119227329 | Revenue |
| Description | ACUTE HOSPITAL AND EMERGENCY ROOM CARE- PATIENT DAYS 28,371; ER VISITS 30,511; OUTPATIENT VISITS 65,907. THE HOSPITAL ALSO PROVIDES CARE TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. THE AMOUNT OF CHARGES FOREGONE AS CHARITY CARE WAS 1,430,714 FOR THE YEAR ENDED SEPTEMBER 30, 2010 | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 104448674 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 57 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1073 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TJ SAMSON COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2706514444 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 NORTH RACE STREET | AddressLine1 |
| City | GLASGOW | City |
| State | KY | State |
| ZIP Code | 42141 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Institutional TrusteeInstitutionalTrustee | Highest Compensated EmployeeHighestCompensatedEmployee | OfficerOfficer |
|---|---|---|---|---|---|---|---|---|
| ELLEN BALE | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 78 | |||
| CHRIS LAWRENCE | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 78 | |||
| BRENT WRIGHT | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | |||
| KAREN SMALL | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 11726 | |||
| WALTER DAVIS | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 806 | |||
| MIKE BRYANT | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 78 | |||
| MICHAEL SHADOWEN | ||||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | |||
| VENKATA REDDY | ||||||||
| DIRECTOR | 1 | 506035 | 0 | 20593 | X | X | ||
| FOLLIS CROW III | ||||||||
| TREASURER | 1.2 | 0 | 0 | 862 | X | |||
| BUDDY UNDERWOOD | ||||||||
| SECRETARY | 1.2 | 0 | 0 | 78 | X | |||
| HENRY ROYSE | ||||||||
| CHAIRMAN | 1.3 | 0 | 0 | 12342 | X | |||
| DAN FOUTCH | ||||||||
| VICE CHAIRMAN | 1.2 | 0 | 0 | 78 | X | |||
| ANTHONY SUDDUTH | ||||||||
| CFO | 40 | 221580 | 0 | 27322 | X | |||
| WILLIAM KINDRED | ||||||||
| CEO | 40 | 280250 | 0 | 32328 | X | |||
| BOGDAN MARCOL | ||||||||
| PHYSICIAN | 40 | 518220 | 0 | 30804 | X | |||
| VIVEK JAIN | ||||||||
| PHYSICIAN | 40 | 176114 | 0 | 0 | X | |||
| ANUPAMA KAUL | ||||||||
| PHYSICIAN | 35 | 175712 | 0 | 27264 | X | |||
| OLIVIA COICULESCU | ||||||||
| PHYSICIAN | 40 | 235137 | 0 | 28523 | X | |||
| JOHN NESBITT | ||||||||
| PHYSICIAN | 40 | 514080 | 0 | 32091 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2627128 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 225051 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| SURGICAL SOLUTIONS | ||||||
| 702 A BARRETT BLVD | HENDERSON | KY | 42420 | SURGERY | 658145 | |
| ASSOCIATED PATHOLOGY | ||||||
| SUITE 350 3 MARYLAND FARMS | BRENTWOOD | TN | 37244 | PATHOLOGY | 375757 | |
| UNIDINE | ||||||
| 1 GATEWAY CENTER SUITE 751 | NEWTON | MA | 02458 | DINING SERVICES | 539046 | |
| APOGEE MEDICAL MANAGEMENT | ||||||
| 2525 E CAMELBACK ROAD | PHOENIX | AZ | 85016 | HOSPITALIST | 698964 | SUITE 1100 |
| ALLIANCE IMAGING INC | ||||||
| PO BOX 96485 | CHICAGO | IL | 60693 | PET SCAN | 345550 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 24 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 0 | GovernmentGrants |
| All Other Contributions | 5000 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 5000 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| HOSPITAL PROGRAM SERVICE | 622000 | 116598783 | 116598783 | 0 | $0 |
| PARTNERSHIP INCOME | 541900 | 241044 | 230476 | 10568 | $0 |
| OUTSIDE LAB | 621500 | 44379 | 0 | 44379 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 116884206 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1957611 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,957,611 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 188065 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 66248 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 121817 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 121817 | TotalRevenueColumn |
| Related Or Exempt Function Income | 121817 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 1500 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 407 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 1093 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1093 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1093 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| CHILD CARE SERVICES | 624410 | -27528 | 0 | -56849 | $29,321 |
| LAUNDRY | 812300 | 240 | 0 | 240 | $0 |
| PRIME ADVANTAGE | 624100 | 9475 | 9475 | 0 | $0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 403325 | TotalRevenueColumn |
| Related Or Exempt Function Income | 161176 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $242,149 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 385512 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 119355239 | TotalRevenueColumn |
| Related Or Exempt Function Income | 117122820 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -1662 | UnrelatedBusinessRevenue |
| Exclusion | $2,229,081 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 508782 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 508782 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46457660 | Total |
| Program Services | 41347317 | ProgramServices |
| Management And General | 5110343 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3371576 | Total |
| Program Services | 3000703 | ProgramServices |
| Management And General | 370873 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5777731 | Total |
| Program Services | 5142181 | ProgramServices |
| Management And General | 635550 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3323793 | Total |
| Program Services | 2958176 | ProgramServices |
| Management And General | 365617 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 341409 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 341409 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52350 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 52350 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121848 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 121848 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2823414 | Total |
| Program Services | 2823414 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393567 | Total |
| Program Services | 393567 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 532750 | Total |
| Program Services | 474148 | ProgramServices |
| Management And General | 58602 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1888813 | Total |
| Program Services | 1888813 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 394545 | Total |
| Program Services | 394545 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9645 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 9645 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 219985 | Total |
| Program Services | 219985 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5543288 | Total |
| Program Services | 5543288 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1279491 | Total |
| Program Services | 1279491 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SUPPLIES | 19774912 | 17599672 | 2175240 | 0 |
| REPAIRS | 3337199 | 3337199 | 0 | 0 |
| PROVIDER TAX | 2153902 | 2153902 | 0 | 0 |
| CONTRACT SERVICES | 4910418 | 4910418 | 0 | 0 |
| DUES AND SUBS | 277335 | 277335 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10704520 | Total |
| Program Services | 10704520 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114198933 | Total |
| Program Services | 104448674 | ProgramServices |
| Management And General | 9750259 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2096932 | BOY |
| EOY | 1763265 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43024184 | BOY |
| EOY | 50562584 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18345098 | BOY |
| EOY | 21589355 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116622 | BOY |
| EOY | 4444 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2011621 | BOY |
| EOY | 2211827 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3675314 | BOY |
| EOY | 2763905 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 119002627 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 80983406 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38201739 | BOY |
| EOY | 38019221 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2017395 | BOY |
| EOY | 2017395 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2280980 | BOY |
| EOY | 2594684 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4666779 | BOY |
| EOY | 2700116 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116436664 | BOY |
| EOY | 124226796 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30838081 | BOY |
| EOY | 30240905 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11990174 | BOY |
| EOY | 10932482 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1663209 | BOY |
| EOY | 914059 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44491464 | BOY |
| EOY | 42087446 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71945200 | BOY |
| EOY | 82139350 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71945200 | BOY |
| EOY | 82139350 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116436664 | BOY |
| EOY | 124226796 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | 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) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 1 | RalliesDemonstrations |
| Rallies Demonstrations | $12,243 | RalliesDemonstrationsAmount |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 12243 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchC_P2B_S00_L01 | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1 | ReturnReference |
| Explanation | THE HOSPITAL PAID MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION OF WHICH 24% OR 5986 WAS USED FOR LOBBYING ACTIVITIES. THEY ALSO PAID MEMBERSHIP TO THE KENTUCKY HOSPITAL ASSOCIATION OF WHICH 17% OR 6257 WAS FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1961573 | OtherCostOrOtherBasis |
| Book Value | 1961573 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 34167310 | OtherCostOrOtherBasis |
| Depreciation | 15802775 | Depreciation |
| Book Value | 18364535 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1590467 | OtherCostOrOtherBasis |
| Depreciation | 1215504 | Depreciation |
| Book Value | 374963 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 81283277 | OtherCostOrOtherBasis |
| Depreciation | 63965127 | Depreciation |
| Book Value | 17318150 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 38019221 | TotalOfBookValueLandBuildings |
Financial Derivatives FinancialDerivatives
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 0 | TotalOfBookValueSecurities |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CANCER CENTER JOINT VENTURE | Description |
| Book Value | 2594684 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 2594684 | TotalOfBookValueProgramRelated |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| THIRD PARTY SETTLEMENTS | 1099918 |
| OTHER RECEIVABLES | 1324153 |
| INTEREST RECEIVABLE | 182684 |
| INVESTMENT IN PREMIER LLP | 93361 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2700116 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| THIRD PARTY PAYOR SETTLEMENTS | $730,626 |
| PROVIDER TAX PAYABLE | $183,433 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 914059 | TotalOfAmounts |
| Total Revenue | 119355239 | TotalRevenue |
| Total Expenses | 114198933 | TotalExpenses |
| Excess Or Deficit For Year | 5156306 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 457969 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | -$7,076,263 | OtherAmount |
| Total Adjustments | -6618294 | TotalAdjustments |
| Excess Or Deficit Per FS | -1461988 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 119787278 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 457969 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 243959 | OtherRevenues |
| Revenue Not Rptd F990 | 701928 | RevenueNotRptdF990 |
| Revenue Subtotal | 119085350 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 269889 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 269889 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 119355239 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 121249266 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 7050340 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 7050340 | ExpensesNotRptdF990 |
| Expenses Subtotal | 114198926 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 7 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 7 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 114198933 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P10_S00_L00 | Schedule D, Part X | N/A |
| SchD_P11_S00_L08 | Schedule D, Part XI, Line 8 | CHANGE IN PARTNERSHIP INCOME FROM BOOK TO TAX 2,915 CHANGE IN RETIREMENT PLAN -7,050,340 PARTNERSHIP SECTION 1231 AND CAPITAL GAIN PER K-1 -1,088 GIFT SHOP PROFIT -27,757 PARTNERSHIP SECTION 1231 LOSS PER K-1 7 |
| SchD_P12_S00_L02d | Schedule D, Part XII, Line 2d | PARTNERSHIP INCOME RECODED ON BOOK 243,959 |
| SchD_P12_S00_L04b | Schedule D, Part XII, Line 4b | PARTNERSHIP INCOME ON K-1 241,044; PARTERSHIP INVESTMENT INCOME PER K-1 1,088; GIFT SHOP PROFIT 27,757 |
| SchD_P13_S00_L02d | Schedule D, Part XIII, Line 2d | CHANGE IN THE RETIREMENT PLAN |
| SchD_P13_S00_L04b | Schedule D, Part XIII, Line 4b | PARTNERSHIP SECTION 1231 LOSS |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1497226 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 576851 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 920375 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0081 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 19357301 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11067786 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8289515 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0726 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 20854527 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11644637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9209890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0807 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 584 | NumberOfActivitiesOrPrograms |
| Persons Served | 11246 | PersonsServed |
| Net Community Benefit Expense | 267400 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0023 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 13 | NumberOfActivitiesOrPrograms |
| Persons Served | 43 | PersonsServed |
| Total Community Benefit Expense | 650920 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 650920 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0057 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 113 | NumberOfActivitiesOrPrograms |
| Persons Served | 1277 | PersonsServed |
| Net Community Benefit Expense | 56811 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0005 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 710 | NumberOfActivitiesOrPrograms |
| Persons Served | 12566 | PersonsServed |
| Total Community Benefit Expense | 650920 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 975131 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0085 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 711 | NumberOfActivitiesOrPrograms |
| Persons Served | 12566 | PersonsServed |
| Total Community Benefit Expense | 21505447 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11644637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10185021 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0892 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 196 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 2192 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 2376 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 16647 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 6562 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 27973 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0002 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,650,431 | BadDebtExpenseAmount |
| Amount Attributable To | 1003671 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 31849068 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 35197391 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3348323 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TJ SAMSON COMMUNITY HOSPTAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1304 NORTH RACE STREET | AddressLine1 |
| City | GLASGOW | City |
| State | KY | State |
| ZIP Code | 42141 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | IS REPORTED AS COST THAT IS CALCULATED BY APPLYING THE TOTAL COST TO CHARGES RATION | CostingMethodUsed |
| Subsidized Health Services Expln | N/A | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | N/A | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT THE HOSPITAL EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. THE HOSPITAL PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS THROUGH A PROVISION FOR BAD DEBT EXPENSE AND AN ADJUSTMENT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF THE CURRENT STATUS OF INDIVIDUAL RECEIVABLES FROM CONTRACTS, MEDICAID/MEDICARE, AND OTHERS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION ERRORS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO THE APPLICABLE ACCOUNTS RECEIVABLE. BAD DEBT ON THIS REPORT IS REPORTED AT COST AS CALCULATED BY APPLYING THE TOTAL COST TO CHARGE RATIO TO TOTAL CHARGES WRITTEN OFF TO BAD DEBT. | BadDebtFootnote |
| Shortfall As Community Benefit | COST TO CHARGE METHODLOGY. WE BELIEVE THAT A 100% OF THE SHORTFALL IS COMMUNITY BENEFIT SINCE IT IS AN UNREIMBURSED COST TO THE HOSPITAL FOR PROVIDING A GOVERNMENT PROGRAM. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Yes we have established collection practices that qualify for charity care or financial assistance. | DebtCollectionPolicy |
| Needs Assessment | HOSPITAL PARTICIPATES IN A COMMUNITY NEEDS ASSESSMENT WITH OTHER LOCAL HEALTH PROVIDERS. | NeedsAssessment |
| Patient Education Assistance | PATIENTS ARE NOTIFIED ABOUT THESE PROGRAMS AT REGISTRATION. | PatientEducationAssistance |
| Community Information | HOSPITAL SERVES A 3 COUNTY PRIMARY SERVICE AREA AND AN 8 COUNTY SECONDARY MARKET AREA. | CommunityInformation |
| Community Building Activities | N/A | CommunityBuildingActivities |
| Other Information | THE HOSPITAL GOVERNING BOARD CONSISTS OF LOCAL COMMUNITY MEMBERS. WE HAVE AN OPEN MEDICAL STAFF POLICY AND SURPLUS FUNDS ARE USED TO REPLACE AND EXTEND HEALTHCARE FACILIATIES AND EQUIPMENT. | OtherInformation |
| Affiliated Health Care System | N/A | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VENKATA REDDY | |||||||||||||
| 506035 | 0 | 0 | 0 | 0 | 0 | 16416 | 0 | 0 | 0 | 522451 | 0 | 3432 | 0 |
| WILLIAM KINDRED | |||||||||||||
| 238110 | 0 | 42140 | 0 | 0 | 0 | 19862 | 0 | 12467 | 0 | 312579 | 0 | 0 | 0 |
| ANTHONY SUDDUTH | |||||||||||||
| 189679 | 0 | 31901 | 0 | 0 | 0 | 15375 | 0 | 11947 | 0 | 248902 | 0 | 0 | 0 |
| BOGDAN MARCOL | |||||||||||||
| 518220 | 0 | 0 | 0 | 0 | 0 | 16968 | 0 | 13836 | 0 | 549024 | 0 | 0 | 0 |
| JOHN NESBITT | |||||||||||||
| 514080 | 0 | 0 | 0 | 0 | 0 | 16968 | 0 | 15123 | 0 | 546171 | 0 | 0 | 0 |
| ANUPAMA KAUL | |||||||||||||
| 125232 | 0 | 50480 | 0 | 0 | 0 | 16968 | 0 | 10297 | 0 | 202977 | 0 | 0 | 0 |
| OLIVIA COICULESCU | |||||||||||||
| 235137 | 0 | 0 | 0 | 0 | 0 | 16968 | 0 | 10297 | 0 | 262402 | 0 | 0 | 0 |
| VIVEK JAIN | |||||||||||||
| 176114 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 176114 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11 | Form 990, Part VI, Section B, Line 11 | THE CFO REVIEWED THE 990 AND EMAILED TO BOARD MEMBERS. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | THE BOARD REVIEWS COMPLIANCE |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | THE HOSPITAL HAS AN INDEPENDENT CONSULTANT REVIEW THE SALARIES FOR THE CEO AND CFO. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | ALL ARE AVAILABLE UPON REQUEST |
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